MRI在布氏杆菌脊柱炎和脊柱结核鉴别诊断中的应用价值

目的]探讨MRI在布氏杆菌脊柱炎和脊柱结核鉴别诊断中的应用价值.方法]选择2013年12月至2016年10月本院确诊的布氏杆菌脊柱炎40例、脊柱结核50例,将其分为脊柱炎组与脊柱结核组.对两组患者MRI影像学资料进行分析.结果]脊柱炎组与脊柱结核组在椎体破坏部位前侧、后侧、前后侧(25.00%、60.00%、15.00%)vs(68.00%、16.00%、16.00%)]、椎旁软组织内脓肿(7.50%vs 74.00%)、椎间盘破坏局限、弥漫(45.00%、17.50%)vs(18.00%、40.00%)]、椎间隙狭窄(27.50%vs 50.00%)、椎间盘信号异常(80.00%vs 30.00%)及椎间隙消失(0.00%vs 20.00%)方面比较,差异具有统计学意义(P<0.05);两组发病部位、椎体受累数、后凸畸形发生率比较,差异无统计学意义(P>0.05).结论]布氏杆菌脊柱炎和脊柱结核发病部位、椎体受累数等MRI表现类似,但在椎体破坏部位、椎间隙狭窄等方面MRI表现差异显著,可作为两者鉴别诊断重要MRI征象.

Application Value of MRI in Differential Diagnosis of Brucellar Spondylitis and Spinal Tuber culosis

Objective]To explore the application value of MRI in the differential diagnosis of brucellar spondy-litis and spinal tuberculosis. Methods]The MRI data of 40 cases with brucellar spondylitis and 50 cases with spinal tuberculosis from January 2012 to October 2016 were retrospectively analyzed. Results]There were significant differ-ences between the brucellar spondylitis group and the spinal tuberculosis group in the sites of destroyed vertebral bodies front side, back side and both sides (25.00%, 60.00%, 15.00%) vs (68.00%, 16.00%, 16.00%)], ab-scess in paravertebral soft tissues (7.50% vs 74.00%), intervertebral disc destruction limited, diffuse (45.00%, 17.50%) vs (18.00%, 40.00%)], intervertebral space stenosis (27.50% vs 50.00%), intervertebral disc signal abnormalities (80.00% vs 30.00%) and intervertebral space disappearance (0.00% vs 20.00%) ( P<0.05). The pathogenic sites, number of vertebral involvement and the incidence of kyphosis showed no significant differences ( P>0.05) . Conclusion] The MRI findings such as pathogenic sites and number of vertebral involvement in brucellar spondylitis and spinal tuberculosis are similar, but the differences in the sites of vertebral destruction and interverte-bral space stenosis are significant, which can be used as important MRI signs for the differential diagnosis of the two diseases.