摘要
目的综合DR、CT及MRI影像学表现,分析总结不同阶段腰椎布鲁杆菌脊柱炎影像学特点,为进行腰椎布鲁杆菌脊柱炎影像学分期提供前期参考。方法对49例腰椎布鲁杆菌脊柱炎患者行同期腰椎DR、CT及MRI检查。根据发病部位、椎体及椎间隙炎症浸润和破坏程度、椎旁及椎管内脓肿范围等征象进行分析,对所有病例影像学表现进行归纳总结。结果腰椎布鲁杆菌脊柱炎病变的影像学进展过程大致可分为:(1)早期改变:DR、CT影像基本正常,MRI显示椎间盘、椎体及椎旁异常炎性信号。(2)中期改变:DR片显示受累节段椎间隙高度正常或变窄;CT显示椎间终板有小溶骨破坏灶及增生硬化;MRI显示椎间、椎体炎性信号,椎管内、椎旁局限性脓肿。(3)晚期改变:DR片显示受累椎间隙变窄,终板显示欠清,可见骨赘增生;CT显示椎体增生与溶骨性破坏并存,椎体周缘呈"花边样"外观;MRI显示椎间、椎体炎性信号,椎管内、椎旁脓肿较为广泛。结论腰椎布鲁杆菌脊柱炎不同病期在影像学上有不同特征,通过综合DR、CT及MRI检查对各阶段腰椎布鲁杆菌脊柱炎进行影像学分析与归纳,可进一步认识各病期的变化,为针对性治疗提供影像学参考,并为影像学分期提供了前期资料。
Objective The imaging features of different stages of spondylitis of Brucella lumbar vertebrae are analyzed and summarized according to the DR,CT and MRI imaging findings,which provide a preliminary reference for imaging staging of Brucella spondylitis in lumbar vertebrae. Methods The 49 cases of lumbar Brucella spondylitis were recruited in this study,and lumbar DR,CT scan and 3 D reconstruction,MRI were carried out. The DR,CT and MRI of each patient were analyzed according to the location,the inflammation and damage degree of vertebrae and intervertebral disc,and the range of paravertebral and intraspinal abscess. Finally,the imaging findings of all cases were summarized. Results The progression of lumbar Brucella spondylitis on imageology could be roughly divided into three parts：（1） Early change： no abnormality was seen in DR and CT,but high signals could be detected in vertebrae and paravertebral area by MRI.（2） Middle change： lumbar DR showed disc height could be normal or a little narrow. Small osteolytic lesions and hyperplastic sclerosis could be found in CT. MRI revealed inflammatory signals and localized abscess in vertebrae and intervertebral disc.（3） Late change： DR showed obvious narrow of disc height,unclear endplate and vertebral body osteophyte; CT showed osteolytic and inflammatory osteophytosis coexisted in the vertebral body; MRI showed inflammatory signal in intra-spinal and/or para-spinal areas following with extensive abscesses formation. Conclusions There are different imaging findings in different stages of Brucella spondylitis in lumbar spine. By combining DR,CT and MRI image in different courses,to analyze and sum up the image of Brucella spondylitis in lumbar spine,it can further understand the changes of the disease in each disease period,provide imaging reference for targeted treatment,and provide preliminary data for future imaging staging.
作者
原杰
赵斌
王永峰
王智权
赵伟
王少伟
赵轶波
陆向东
YUAN Jie, ZHAO Bin, WANG Yong-feng, WANG Zhi-quan, ZHAO Wei, WANG Shao-wei, ZHAO Yi-bo, LU Xiang-dong(Dept of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China)
出处
《临床骨科杂志》
2018年第4期424-428,共5页
Journal of Clinical Orthopaedics
基金
山西省自然科学基金(编号:2013011046-8)
国家自然科学基金(编号:81572207)
关键词
腰椎
布鲁杆菌脊柱炎
脊柱影像学
lumbar vertebra
Brueella spondylitis
spinal imaging
