新发传染病电子杂志2024，Vol.9Issue(6)：26-31,6.DOI:10.19871/j.cnki.xfcrbzz.2024.06.005
MRI在布鲁氏菌病患者早期脊柱炎与Modic Ⅰ型脊柱退行性病变的鉴别诊断价值
The value of MRI in differentiating Modic type Ⅰ spinal degenerative changes from early spondylitis in patients with brucellosis
摘要
Abstract
Objective To explore the application value of MRI in the differential diagnosis of early spondylitis in brucellosis patients and Modic type Ⅰ spinal degeneration,and to provide imaging reference for the differential diagnosis of the two.Method Fifteen patients diagnosed with early brucellosis spondylitis admitted to the People's Hospital of Inner Mongolia Autonomous Region from January 2020 to May 2024 were selected as the BS group,and 17 patients with lumbar Modic type Ⅰ spinal degeneration were selected as the M Ⅰ group.All patients underwent MRI examination.The morphology,signal,bone change and enhanced image pattern of the diseased vertebral body and adjacent discs of the two groups were compared respectively.Result The 15 patients in BS group had 28 vertebral body lesions,with an average age of 47.88 years.A total of 27 vertebral bodies were involved in 17 patients in M Ⅰ group with an average age of 53.60 years.Vertebrae prone to lesions in BS group:L4,accounting for 28.57％(8/28);The lesions were mainly characterized by hypointense on T1WI(13/28,46.43％),clear boundary on T2WI(24/28,85.71％)and discontinuous end-plate contour on T1WI(24/28,85.71％).No positive DWI claw sign was found.Lesion enhancement 100％(17/17);10.71％(3/28)of the vertebral bodies had bone destruction.Most lesions were fan-shaped or stripe-shaped(23/28,82.14％).T2WI hyperintensity of intervertebral disc was 83.33％(15/18).In M Ⅰ group,the lesion was L5,accounting for 33.33％(9/27),and the lesion was mainly iso-hypointensity such as T1WI(18/27,66.67％).The incidence of hyperintense in T1WI was 11.11％(3/27).The main lesions were blurred boundary on T2WI(18/27,66.67％)and continuous endplate contour on T1WI(22/27,81.48％).DWI claw positive 100％(7/7);Lesion enhancement 100％(7/7);Some vertebrae had bone destruction 14.81％(4/27);Segment or strip shape of the lesion 62.96％(17/27).Intervertebral disc T2WI hyperintense accounted for 20.00％(3/15).Conclusion DWI claw sign is positive,indicating MⅠclearly.T1WI endplate contour is continuous,MⅠ possibility is high;Involved intervertebral disc T2WI hyperintense,BS is more likely;T1WI hyperintense appeared in the lesion,indicating M Ⅰ.The above features are significant for the differential diagnosis of early spondylitis in brucellosis patients and Modic Ⅰ spinal degeneration.Lesion morphology and enhancement have little value in the differential diagnosis of the two,and are not recommended as differential indicators.关键词
布鲁氏菌病/脊柱炎/Modic Ⅰ型脊柱退行性病变/磁共振成像Key words
Brucellosis/Spondylitis/Modic type Ⅰ spinal degeneration/Magnetic resonance imaging分类
医药卫生引用本文复制引用
李俊林,丁海涛,王丽娜,尹松涛,赵楠..MRI在布鲁氏菌病患者早期脊柱炎与Modic Ⅰ型脊柱退行性病变的鉴别诊断价值[J].新发传染病电子杂志,2024,9(6):26-31,6.基金项目
1.内蒙古医学科学院公立医院科研联合基金科技项目(2023GLLH0060) （2023GLLH0060）
2.内蒙古自治区卫生健康委医疗卫生科技计划项目(202201054) （202201054）
3.内蒙古自治区医师协会临床医学研究和临床新技术推广项目(YSXH2024KYF001) （YSXH2024KYF001）
