布氏杆菌性脊柱炎的CT、MRI诊断

CT and MRI Diagnosis of Brucella Spondylitis

目的:探讨布氏杆菌性脊柱炎的CT、MRI表现,以提高对该病的诊断及鉴别诊断水平。方法:搜集行多层螺旋CT及1.5T MRI平扫并经手术病理明确或临床随访证实的17例布氏杆菌性脊柱炎,回顾性分析其CT、MRI资料,结合文献探讨其影像特征。结果:本组17例病变共累及37个椎体,以腰4椎体受累最多见,达40.5%(15/37)。CT表现为椎体边缘性破坏同时有骨质增生硬化,椎体边缘呈"花边椎"改变,硬化椎体内可见新的小破坏灶,呈"盐"中镶嵌"西瓜子"征,无死骨形成,部分病变椎旁韧带钙化,椎体无压缩塌陷;MRI除上述CT表现外显示椎旁脓肿量较少或无,脓肿与腰大肌分界较清晰,其内无钙化。结论:布氏杆菌性脊柱炎CT、MRI表现具有一定的特征性,结合患者弛张热、流行病学特点及实验室检查可明确诊断。

Objective：The purpose： To discuss the manifestations of CT and MRI of brucellar spondylitis to improve the level of diagnosing and treating this disease. Methods：17 cases of brucellar spondylitis, who are diagnosed by multi-slice spiral CT and 1.5T MRI plain scan, determined by surgery pathology or confirmed by clinical follow-up, make a retrospective analysis on their CT and MRI data, and discuss image features along with related papers. Results：17 pathological changes in this group involve 37 centrums altogether, in which troubled lumber vertebrae 4 is common to see, amounting to 40.5%（15/37）.CT shows that there is marginal damage of the centrum as well as hyperostosis osteosclerosis. The margin of centrum shows ＂lace-like＂ changes. There is new little damage oven with the harden centrum with the image like ＂watermelon seeds＂ embedded in ＂salt＂. No sequestrum took shape, some lesion centrum became calcified, and centrum did not suffer compressed collapse; In addition to the above CT manifestations, MRI shows that there is little or no paravertebral abscess and the abscess has clearer boundary with psoas major muscle, within which there is no calcification. Conclusions：There are some characteristics of the representation of CT and MRI of rachitis with bacterium Brucella.. We can make a definite diagnosis by combining with the characteristics of patient’s remittent fever, epidemic disease and examination in laboratory.