The value of MRI in differentiating Brucella spondylitis from tuberculosis spondylitis / 中华地方病学杂志

ABSTRACT

Objective:To evaluate the value of magnetic resonance imaging (MRI) in differentiating Brucella spondylitis from tuberculosis spondylitis. Methods:A retrospective analysis method was used to include Brucella spondylitis patients and tuberculous spondylitis patients who had undergone MRI examination at the First Affiliated Hospital of Xinjiang Medical University from January 2015 to December 2017. All patients data of MRI examination (all had T1WI, T2WI, STIR images) were collected and compared. The differences in lesion location, MRI signal, vertebral body destruction, vertebral wedge, kyphosis deformity, attachment destruction, dead bone, bone hyperplasia, intervertebral space change, abscess location, and abscess range were analyzed. Results:A total of 91 patients with brucella spondylitis were selected, including 36 women and 55 men, with an average age of 49.40 years old; 112 patients with tuberculous spondylitis selected in the same examination, including 48 women and 64 men, with an average age of 47.15 years old. There was no statistically significant difference in gender and age between the two groups (χ 2 = 0.225, t = 1.387, P > 0.05). Brucella spondylitis was more common in lumbar spine [72.53% (66/91)], and tuberculosis spondylitis was more common in thoracic spine [47.32% (53/112)]. Brucella spondylitis patients showed higher T2WI hyperintensity than tuberculosis spondylitis patients [51.65% (47/91) vs 24.11% (27/112), P <0.05]; and showed lower T2 hyperlipidemia than patients with tuberculosis spondylitis [59.34% (54/91) vs 72.32% (81/112), P < 0.05]; the incidence rates of mild destruction of vertebral body, bone hyperplasia, normal intervertebral space, paravertebral abscess, and abscess not exceeding the range of vertebral body were higher than those of patients with tuberculosis spondylitis [81.32% (74/91), 93.41% (85/91), 37.36% (34/91), 71.43% (65/91), 38.46% (35/91) vs 20.54% (23/112), 28.57% (32/112), 1.79% (2/112), 30.36% (34/112), 1.79% (2/112), P < 0.01]; the incidence rates of vertebral body severe destruction, vertebral wedge less than 1/2, kyphosis deformity, dead bone, inter vertebral space narrowing, inter vertebral space vanishing, psoas abscess, abscess beyond the range of vertebral body were lower than those of patients with tuberculous spondylitis [12.09% (11/91), 18.68% (17/91), 2.20% (2/91), 2.20% (2/91), 61.54% (56/91), 1.10% (1/91), 2.20% (2/91), 1.10% (1/91) vs 75.89% (85/112), 72.32% (81/112), 29.46% (33/112), 46.43% (52/112), 79.46% (89/112), 18.75% (21/112), 66.96% (75/112), 74.11% (83/112), P < 0.01]. Conclusions:MRI signs can be used to differentiate Brucella spondylitis from tuberculosis spondylitis through analysis of bone hyperplasia, vertebral body destruction, vertebral wedge, kyphosis deformity, dead bone, abnormal intervertebral space, and paravertebral abscess and psoas abscess.