【摘要】 目的探讨磁共振成像(MRI)在布氏杆菌性脊柱炎(BS)与脊柱结核(TS)鉴别诊断中的应用价值。方法回顾性分析2016年1月～2018年12月在我院明确诊断的35例BS患者及33例TS患者的MRI影像资料,对二者的MRI影像特征进行统计分析。结果受累椎体异常信号上,TS组以弥散型信号为主,占比85.87%;BS组局灶型、扇形信号比例分别为27.71%、21. 69%,明显高于TS组的14.13%、0.00%(P<0.05)。TS组椎体塌陷及脊柱后凸畸形发生率分别为42.39%、21.74%,均明显高于BS组的0%、3.61%(P<0.05)。两组硬膜外脓肿、硬膜外脓肿伴神经症状、前纵韧带下脓肿发生率比较均无统计学差异(P>0.05),TS组韧带下脓肿扩散≥3个椎体水平发生率明显高于BS组(P<0.05)。结论 BS、TS在骨质破坏程度、脓肿扩散程度、椎体信号形态上有明显差异,这有助于二者在MRI影像上的鉴别诊断。更多还原

【Abstract】 Objective To explore the application value of magnetic resonance imaging(MRI) in the differential diagnosis of brucellar spondylitis(BS) and tuberculosis spondylitis(TS). Methods MRI imaging data of 35 patients with BS and 33 patients with TS who were diagnosed in our hospital from January 2016 to December 2018 were retrospectively analyzed. The MRI features of the two were statistically analyzed. Results In the abnormal vertebral body signal, TS group was dominated by diffuse signals, accounting for 85.87%. The proportions of focal and sector signals in BS grouPwere 27.71% and 21.69% respectively, which were significantly higher than those in TS grouPwith 14.13% and 0.00%(P<0.05). The incidence rates of vertebral collapse and kyphosis were 42.39% and 21.74% respectively in TS group, which were significantly higher than those in BS grouPwith 0% and 3.61%(P<0.05). There were no significant differences in the incidence rates of epidural abscess, epidural abscess with neurological symptoms and abscess under anterior longitudinal ligament between the two groups(P>0.05). The incidence rate of abscess diffusion≥ 3 vertebral bodies in TS grouPwas significantly higher than that in BS grouP(P<0.05). Conclusion BS and TS have significant differences in the bone destruction degree, abscess diffusion degree and morphology of vertebral body signals, which is helpful for the differential diagnosis of the two in MRI images.更多还原