MRI在布氏杆菌脊柱炎诊断中的应用价值

发布时间：2018-01-12 23:17

本文关键词：MRI在布氏杆菌脊柱炎诊断中的应用价值　出处：《山东大学学报(医学版)》2016年06期 　论文类型：期刊论文

【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T_1-WI、T_2-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。T_1-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。T_2-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。
[Abstract]:Objective to investigate the specific manifestations of brucellae spondylitis on magnetic resonance imaging (MRI). Methods 26 patients with brucella spondylitis were retrospectively analyzed, including in T1-WI. T2-WI and lipid-compression images of the disease. The location of the disease, intervertebral disc and vertebral body involvement signal, degree of destruction, the formation and diffusion of the spinal canal abscess, and so on were statistically analyzed. Results 26 cases of brucella spondylitis involved the lumbar vertebrae and sacrum in 22 cases, and the thoracic vertebrae in 4 cases. There were 62 involved vertebrae in 3 cases of jumping disease and 36 cases of affected intervertebral disc on T1-WI. The involved vertebrae showed low signal intensity, 23 vertebral discs showed normal signal intensity. T2-WI showed that the involved vertebrae showed normal signal intensity, and 18 vertebral bodies showed mixed signals. The involved intervertebral disc showed high signal intensity. 45 vertebral bodies and 28 intervertebral discs showed high signal intensity. The signal signals of the involved vertebral bodies showed local type and the fan-shaped vertebral bodies were 31 / 50). The characteristic inflammatory response lines were often found in the involved intervertebral discs of 31 vertebral bodies with diffuse lesions. 56% of all the involved intervertebral discs were involved. In all the involved vertebral bodies, 28 vertebral bodies were destroyed in the peri-disc type bone, and no significant bone destruction was seen in the remaining vertebrae in 2 cases of kyphosis deformities. There were 12 cases of intramedullary abscess and 12 cases of sublongitudinal ligament abscess, of which 1 case spread more than 3 vertebrae and 7 cases were smaller than 3 vertebrae. Conclusion MRI has a high clinical value in the diagnosis of brucellae spondylitis.
【作者单位】：山东大学附属省立医院脊柱外一科;
【分类号】：R516.7
【正文快照】： 布氏杆菌病是一种世界范围内的动物性传染病,多见于地中海沿岸、中东及拉丁美洲等地区[1-2]。可累及造血系统、泌尿生殖系统、骨骼肌肉组织等全身多个系统[3-5]。布氏杆菌脊柱炎是布氏杆菌病常见的并发症,可造成脊柱畸形和瘫痪等严重后果,因此迅速而准确的诊断至关重要。发热

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