本文選題：布氏桿菌性脊柱炎　切入點(diǎn)：脊柱結(jié)核　出處：《新疆醫(yī)學(xué)》2017年02期

【摘要】：目的探討布氏桿菌性脊柱炎與脊柱結(jié)核的MRI表現(xiàn),旨在提高二者的鑒別診斷水平。方法回顧性分析經(jīng)臨床或手術(shù)病理證實(shí)的32例布氏桿菌性脊柱炎和55例脊柱結(jié)核患者M(jìn)RI表現(xiàn),進(jìn)行對(duì)比分析。結(jié)果32例布氏桿茼性脊柱炎患者共67個(gè)椎體受累,多發(fā)生于腰椎,胸椎次之,受累椎體骨質(zhì)破壞較輕,塌陷畸形較少(12/32),致后凸畸形較少(5/32),椎體周邊常伴有明顯增生硬化(20/32),椎旁膿腫較輕范圍小(11/32),椎間盤(pán)破壞較輕,椎間隙狹窄較少(10/32),很少發(fā)生死骨或鈣化;55例脊柱結(jié)核患者共120個(gè)椎體受累,好發(fā)于胸腰段椎體,骨質(zhì)破壞明顯,易致塌陷畸形(40/55)、脊柱后凸畸形(23/55),椎間盤(pán)破壞及椎間隙狹窄明顯(33/55),常伴有死骨及鈣化形成(14/55),椎旁膿腫常見(jiàn)且范圍較廣(29/55);布氏桿茼性脊柱炎與脊柱結(jié)核在病變椎體分布及椎旁膿腫形成方面差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),在椎體塌陷畸形,椎間盤(pán)破壞及狹窄,死骨或鈣化形成,椎體增生硬化,后凸畸形這幾個(gè)方面差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論根據(jù)觀察布氏桿菌性脊柱炎與脊柱結(jié)核的MRI特征性表現(xiàn),結(jié)合病史資料及實(shí)驗(yàn)室檢查,有助于兩者的鑒別診斷。
[Abstract]:Objective to investigate the MRI findings of brucellosis and spinal tuberculosis in order to improve their differential diagnosis.Methods the MRI findings of 32 cases of Brucella spondylitis and 55 cases of spinal tuberculosis proved clinically or surgically and pathologically were analyzed retrospectively.Results Sixty-seven vertebrae were involved in 32 patients with brucellitis, most of them were involved in lumbar vertebrae, followed by thoracic vertebrae.Collapsing deformities are less than 12 / 32, kyphosis is less than 5 / 32, vertebrae is often accompanied by obvious hyperplasia and sclerosis of 20 / 32, paravertebral abscess is lighter in the range of 11 / 32, and disc destruction is lighter.The vertebral space stenosis was less than 10 / 32, and there were seldom dead bones or calcifications in 55 patients with spinal tuberculosis. There were 120 vertebrae involved, which occurred easily in the thoracolumbar vertebrae, and the destruction of bone was obvious.Prone to collapse deformities 40 / 55, kyphosis 23 / 55, disc destruction and intervertebral space stenosis significant 33 / 55, often accompanied by dead bone and calcification to form 14 / 55, paravertebral abscess is common and has a wide range of 29 / 55; Brinell's stem spondylitis and spinal tuberculosis are divided into diseased vertebrae.There was no significant difference in the formation of paravertebral abscess between cloth and paravertebral abscess.There were significant differences in the destruction and stenosis of intervertebral disc, the formation of dead bone or calcification, hyperplasia and sclerosis of vertebral body and kyphosis.Conclusion according to the MRI characteristics of brucella spondylitis and spinal tuberculosis, combined with the history and laboratory examination, it is helpful for the differential diagnosis of the two.
【作者單位】： 新疆阿克蘇地區(qū)第一人民醫(yī)院影像中心;
【分類(lèi)號(hào)】：R529.2;R516.7;R445.2

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