布氏杆菌性脊柱炎与脊椎结核的MRI表现及鉴别诊断

发布时间：2018-04-10 01:00

本文选题：布氏杆菌性脊柱炎　切入点：脊柱结核　出处：《新疆医学》2017年02期

【摘要】：目的探讨布氏杆菌性脊柱炎与脊柱结核的MRI表现,旨在提高二者的鉴别诊断水平。方法回顾性分析经临床或手术病理证实的32例布氏杆菌性脊柱炎和55例脊柱结核患者MRI表现,进行对比分析。结果32例布氏杆茼性脊柱炎患者共67个椎体受累,多发生于腰椎,胸椎次之,受累椎体骨质破坏较轻,塌陷畸形较少(12/32),致后凸畸形较少(5/32),椎体周边常伴有明显增生硬化(20/32),椎旁脓肿较轻范围小(11/32),椎间盘破坏较轻,椎间隙狭窄较少(10/32),很少发生死骨或钙化;55例脊柱结核患者共120个椎体受累,好发于胸腰段椎体,骨质破坏明显,易致塌陷畸形(40/55)、脊柱后凸畸形(23/55),椎间盘破坏及椎间隙狭窄明显(33/55),常伴有死骨及钙化形成(14/55),椎旁脓肿常见且范围较广(29/55);布氏杆茼性脊柱炎与脊柱结核在病变椎体分布及椎旁脓肿形成方面差异无统计学意义(P0.05),在椎体塌陷畸形,椎间盘破坏及狭窄,死骨或钙化形成,椎体增生硬化,后凸畸形这几个方面差异有统计学意义(P0.05)。结论根据观察布氏杆菌性脊柱炎与脊柱结核的MRI特征性表现,结合病史资料及实验室检查,有助于两者的鉴别诊断。
[Abstract]:Objective to investigate the MRI findings of brucellosis and spinal tuberculosis in order to improve their differential diagnosis.Methods the MRI findings of 32 cases of Brucella spondylitis and 55 cases of spinal tuberculosis proved clinically or surgically and pathologically were analyzed retrospectively.Results Sixty-seven vertebrae were involved in 32 patients with brucellitis, most of them were involved in lumbar vertebrae, followed by thoracic vertebrae.Collapsing deformities are less than 12 / 32, kyphosis is less than 5 / 32, vertebrae is often accompanied by obvious hyperplasia and sclerosis of 20 / 32, paravertebral abscess is lighter in the range of 11 / 32, and disc destruction is lighter.The vertebral space stenosis was less than 10 / 32, and there were seldom dead bones or calcifications in 55 patients with spinal tuberculosis. There were 120 vertebrae involved, which occurred easily in the thoracolumbar vertebrae, and the destruction of bone was obvious.Prone to collapse deformities 40 / 55, kyphosis 23 / 55, disc destruction and intervertebral space stenosis significant 33 / 55, often accompanied by dead bone and calcification to form 14 / 55, paravertebral abscess is common and has a wide range of 29 / 55; Brinell's stem spondylitis and spinal tuberculosis are divided into diseased vertebrae.There was no significant difference in the formation of paravertebral abscess between cloth and paravertebral abscess.There were significant differences in the destruction and stenosis of intervertebral disc, the formation of dead bone or calcification, hyperplasia and sclerosis of vertebral body and kyphosis.Conclusion according to the MRI characteristics of brucella spondylitis and spinal tuberculosis, combined with the history and laboratory examination, it is helpful for the differential diagnosis of the two.
【作者单位】：新疆阿克苏地区第一人民医院影像中心;
【分类号】：R529.2;R516.7;R445.2

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