布氏杆菌性脊柱炎的CT及MRI表现

The CT and MRI Findings of Brucellosis Spondylitis

目的探讨布氏杆菌性脊柱炎(BS)的CT及MRI表现,以提高对本病的诊断及鉴别诊断水平。方法回顾性分析2013年至2015年本院经临床和/或病理证实的40例BS患者CT及MRI表现特点。结果 BS可侵犯脊柱任何部位,以腰椎最多,最易累及L4椎体,受累椎体骨膜增厚,边缘性骨质破坏伴有骨质增生硬化,使椎体边缘呈"花边椎"改变,小破坏区无死骨,破坏范围较大时可见死骨,椎体形态变化不大,椎间盘破坏轻,椎周脓肿局限无流注,其内无钙化,多不累及腰大肌。结论 BS的影像学表现具有特征性,CT及MRI能为BS的诊断提供影像学依据,具有较高临床价值。

Objective To explore CT and MRI findings of brucellosis spondylitis,in order to improve its diagnosis and differential diagnoses. Methods The MSCT and MRI features of 40 patients who were diagnosed of brucellosis spondylitis with clinical or pathological evidences from 2013 to 2015 in our hospital,were retrospectively analyzed. Results Brucellosis spondylitis can affect any segment of the spinal column,but generally attacks the lumbar vertebrae,and commonly occurs on the third lumbar vertebra. The vertebral body had periosteal thickening,and there is marginal damage of the centrum as well as hyperostosis osteosclerosis,which make centrum brim display ＂ lace-like＂ changes. Sequestrum can be present when the range of bone destruction was more extensive. Morphology of vertebral body was almost normal with slight intervertebral disc destruction. Paraspinal abscess is limited and has no tracking phenomenon,without internal calcifications. The boundary between paraspinal abscess and psoas was clear. Conclusion The CT and MRI findings of brucellosis spondylitis are characteristic,which can provide important imaging basis for the diagnosis of brucellosis spondylitis.