布氏杆菌性脊柱炎的MRI表现

目的分析布氏杆菌性脊柱炎的MRI表现,从而进一步提高对该病的认识及诊断水平。材料与方法对13例经临床或手术病理确诊为布氏杆菌性脊柱炎患者的临床及MRI资料进行回顾性分析。结果 13例中,12例为相邻2个椎体受累,主要累及腰椎,尤以腰4发病率最高。MRI表现:椎体形态多无明显变化;2例椎体未见明显骨质破坏,仅表现为骨髓水肿改变;骨质破坏11例,破坏灶小而多发,多局限于椎体边缘,T1WI呈均匀或不均匀低信号,STIR呈不均匀高信号,增强后不均匀强化,骨质破坏周围伴骨髓水肿及骨质硬化;椎体边缘明显骨质增生8例;12例椎间盘有炎性改变,椎间隙多无或轻度变窄;13例均有椎旁软组织肿胀,其中3例形成椎旁脓肿,2例形成硬膜外脓肿,脓肿范围较小,增强扫描脓肿壁厚而不规则强化。结论布氏杆菌性脊柱炎的MRI表现具有一定的特征性,MRI对本病的诊断与鉴别诊断具有重要价值。

MRI features of brucellosis spondylitis

Objective:To analyse MRI findings of brucellosis spondylitis(BS) and to improve the knowledge and diagnosis of this disease. Materials and Methods:The clinical date and MRI of 13 cases with clinically or histopathologically proved BS were retrospectively analysed.Results:Of 13 patients with BS, the adjacent vertebral body involved in 12 cases. BS mainly affected the lumber spine, mostly the L4. MRI findings included:Morphology of vertebral body showed no obvious change. Two cases showed marrow oedema only with no obvious bone destruction. Bone destruction were detected in 11 cases, which was small and multiple and was often focaled with the edge of vertebral body. Abnormal vertebral body showed homogeneous or heterogeneous hypointensity on T1WI and heterogeneous hyperintensity on STIR, and heterogeneous enhancement on enhanced scan. Bone destruction was accompanied by marrow oedema and osteosclerosis. Eight cases showed obvious osterphyte in the rim of vertebral body. Twelve cases showed disc involvement, intervertebral space was often normal or slightly narrowed. Paraspinal soft tissue swelling was shown in 13 cases, in which paraspinal abscess was formed in 3 cases and epidural abscess in 2 cases. The abscess was small with thick and irregular enhanced wall on enhanced scan.Conclusions: MRI of BS shows certain characteristics, which are helpful in diagnosis and differential diagnosis of this disease.