布氏杆菌性脊柱炎与脊柱结核的影像特征差异分析

The difference of imaging between spondylitis caused by brucella infection and spinal tuberculosis

目的分析布氏杆菌性脊柱炎与脊柱结核的影像学表现差异,提高对2种疾病的诊断及鉴别诊断的水平,从而减少误诊率。方法收集新疆医科大学附属中医医院2015年1-12月诊治的经影像学检查和经病理学检查证实的26例脊柱结核患者(脊柱结核组)及18例布氏杆菌性脊柱炎患者(布氏杆菌性脊柱炎组),对两组病人的影像学资料进行比较分析。结果脊柱结核与布氏杆菌性脊柱炎在性别及年龄上无差别。与脊柱结核影像特征相比,布氏杆菌性脊柱炎不易造成椎体楔形改变,椎间隙往往正常,不易后凸畸形,骨质疏松少见,骨质破坏相对轻,破坏部位仅仅局限于椎体边缘,呈"岛屿状",更易破坏椎小关节;易出现关节面增生硬化,呈"花边椎",死骨少见,椎间盘信号异常多见,但椎间隙消失少见;易出现邻近椎体韧带钙化(P<0.05)。结论布氏杆菌性脊柱炎和脊柱结核的影像学表现有其不同特征,有助于对两者进行诊断及鉴别诊断。

Objective We conducted the analysis of imaging findings between spondylitis caused by brucells infection and spinal tuberculosis to improve the clinic diagnosis.Methods 26 cases of spinal tuberculosis and 18 cases of spondylitis caused by brucella infection who had laboratory examination,imaging examination and confirmed by pathologic examination in our hospital were collected and the imaging findings between two groups were compared.Results There were no difference in gender and age between two groups.Comparing with the patients of spinal tuberculosis,the imaging findings of spondylitis caused by brucella infection showed less vertebral wedge change,more normal intervertebral space,which had rare rates of kyphosis and osteoporosis and were prone to form hyperplasia and sclerosis of articular surface,more abnormal signals between intervertebral disc,rare facet joint destruction and more calcification of paravertebral ligaments（P〈0.05）.Conclusion There were many differences imaging findings between spondylitis caused by brucella infection and spinal tuberculosis,they were contributed to improve the clinic diagnosis.