MRI在布氏杆菌脊柱炎诊断中的应用价值

doi:10.6040/j.issn.1671-7554.0.2015.1342

摘要/Abstract

摘要： 目的探讨布氏杆菌脊柱炎在磁共振成像(MRI)上的特异性表现。方法回顾性分析26例布氏杆菌脊柱炎患者MRI,包括在T₁-WI、T₂-WI和压脂像上的发病特点。对该病的好发部位、椎间盘与椎体的受累信号、破坏程度、椎管内外脓肿形成及其扩散范围等情况进行统计分析,总结布氏杆菌脊柱炎的MRI影像学特点。结果 26例布氏杆菌脊柱炎患者累及腰椎和骶椎22例(85%),胸椎4例(15%),无颈椎受累患者。跳跃性发病3例(12%)。26例患者共有受累椎体62个,受累椎间盘36个。T₁-WI显示,50个(81%)受累椎体表现为低信号,23个(64%)受累椎间盘表现为正常信号。T₂-WI显示,18个(29%)受累椎体表现为混合信号,19个(53%)受累椎间盘表现为高信号。压脂像上, 45个(73%)受累椎体和28个(78%)受累椎间盘表现为高信号。受累椎体病变信号表现为局部型、扇形病变椎体31个(50%),弥散性病变椎体31个(50%)。受累椎间盘中多可见特征性的炎性反应线,占全部受累椎间盘的56%(20/36)。在全部受累椎体中间盘周围型骨破坏椎体28个(45%),余椎体未见明显骨质破坏。2例脊柱后凸畸形,12例椎管内脓肿,12例前纵韧带下脓肿,其中1例脓肿蔓延超过3个椎体,7例小于3个椎体,4例无脓肿扩散。结论 MRI 在诊断布氏杆菌脊柱炎方面具有较高的临床诊断价值。

关键词: 脊柱感染, 布氏杆菌脊柱炎, 磁共振, 诊断, 布氏杆菌

Abstract: Objective To explore the characteristics of Brucellar spondylitis on magnetic resonance image(MRI)for the early diagnosis. Methods The MRI features of 26 patients with Brucellar spondylitis were retrospectively analyzed, including T₁-WI, T₂-WI and fat suppressed phase, the favorite infected segment, different abnormal signal formation and destruction on the infected vertebra and disc, paraspinal abscess formation and the spread range. Results Of all 26 cases, lumbar and sacral spine involvement was observed in 22 cases(85%); thoracic involvement was observed in 4 cases; and no cervical involvement was observed. Skip lesion was observed in 3 cases. Altogether 36 discs and 62 vertebrae were affected. T₁-WI revealed that 50(81%)infected vertebrae and 23(64%)infected discs showed normal signal. T₂-WI revealed that 18(29%)involved vertebrae showed mixed intense signal and 19(53%)infected discs showed hyperintensity. FS-MRI revealed that 45(73%)infected vertebrae and 28(78%)involved discs showed high signal. Half of the infected vertebrae 31(50%)showed focal and fan-shape signal and another half 31(50%)showed diffused signal. An inflammatory reaction line could be observed in 56%(20/36)of the involved discs. Peridiscal bone destruction was observed in 28(45%)of the infected vertebrae. Spinal kyphosis was observed in 2 cases, intraspinal abscess in 12 cases, anterior subligamentous abscess in 12 cases, of which 1 case involved more than 3 vertebrae, 7 cases involved less than 3 vertebrae and 4 cases had no spread of abscess. Conclusion MRI is an effective modality to diagnose Brucellar spondylitis.

Key words: Diagnosis, Brucellar spondylitis, Brucellosis, Spine infection, Magnetic resonance imaging

中图分类号:

R574

高萌,孙建民,蒋振松,崔新刚. MRI在布氏杆菌脊柱炎诊断中的应用价值[J]. 山东大学学报（医学版）, 2016, 54(6): 27-30.

GAO Meng, SUN Jianmin, JIANG Zhensong, CUI Xingang. Diagnostic value of MRI for brucellar spondylitis[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(6): 27-30.

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