3.0T磁共振扩散加权成像对布鲁杆菌脊柱炎诊断效能及预后评估价值观察

3.0 Observation of Diagnostic Efficacy and Prognostic Evaluation of Brubacterium Spondylitis

目的探究3.0T磁共振(MRI)扩散加权成像(DWI)在布鲁杆菌脊柱炎(BS)诊断及预后评估中应用价值。方法选择2018年2月至2020年9月我院收治的经细菌分离检查或血清学检查明确为BS患者50例,行3.0TMRI-DWI检查。分析病变部位及特点,以及MRI表现;另分析不同时期治疗前后椎体平均弥散系数(ADC值)及各向异性分数(FA值)。结果50例患者中共检出受累椎体330个,腰椎197个、胸椎100个、颈椎33个;相邻两个椎体同时受累共35例,单个椎体受累10例;病变急性期14例,亚急性期16例,慢性期20例;治疗前各时期ADC值及FA值比较,差异均无统计学意义(P>0.05);治疗后12个月,慢性期ADC值及FA值均大于亚急性期及急性期,差异有统计学意义(P<0.05);50例患者经治疗后症状均得到改善,布鲁杆菌凝集试验呈阴性,治疗后6个月均未见疾病复发。结论采用3.0T MRI-DWI诊断BS应用价值较高,能够于早期发现病变,可为预后评估提供影像学依据,值得推广。

Objective to explore the value of 3.0T magnetic resonance(MRI)diffusion weighted imaging(DWI)in the diagnosis and prognosis evaluation of Brucella spondylitis(BS).Methods from February 2018 to September 2020,50 patients with BS confirmed by bacterial isolation or serological examination were selected for 3.0 tmri-dwi examination.The location and characteristics of the lesions and MRI findings were analyzed;The average diffusion coefficient(ADC)and anisotropy fraction(FA)of vertebral body before and after treatment in different periods were analyzed.Results 330 vertebral bodies,197 lumbar vertebrae,100 thoracic vertebrae and 33 cervical vertebrae were detected in 50 patients;There were 35 cases of simultaneous involvement of two adjacent vertebral bodies and 10 cases of single vertebral body;There were 14 cases in acute stage,16 cases in subacute stage and 20 cases in chronic stage;There was no significant difference in ADC value and FA value before treatment(P>0.05);At 12 months after treatment,the ADC value and FA value in chronic phase were significantly higher than those in subacute phase and acute phase(P<0.05);The symptoms of 50 patients were improved after treatment,and Brucella agglutination test was negative.No disease recurrence was found 6 months after treatment.Conclusion 3.0T MRI-DWI is of high value in diagnosing BS.It can detect the lesions early and provide imaging basis for prognosis evaluation.It is worth popularizing.