MRI differential diagnosis of Brucella spondylitis and spinal tuberculosis / 实用放射学杂志

ABSTRACT

Objective To analyze the MRI features of Brucella spondylitis and spinal tuberculosis,to improve the ability of differential diagnosis. Methods MRI features of 22 cases with Brucella spondylitis and 26 cases with spinal tuberculosis confirmed by laboratory examination and operative pathology were analyzed retrospectively.Results Among 22 cases of Brucella spondylitis,1 7 cases occurred in the lumbar spine (1 3 cases in the lumbar 4 vertebrae),2 cases in the cervical spine,2 cases in the thoracic spine and 1 case in the sacral spine.1 9 cases had normal vertebral morphology,slight bone destruction and extensive edema,3 cases had severe vertebral wedge deformation, 16 cases had marginal bone hyperplasia.15 cases had slight changes in the intervertebral space,with narrow (or normal)or slight destruction of intervertebral disc,7 cases had severe narrowing or disappearance of intervertebral space and serious destruction of intervertebral disc. 13 cases had small paravertebral abscess,and 1 case had large paravertebral abscess.Among 26 cases of spinal tuberculosis,20 cases occurred in the lumbar spine (11 cases in the 4th and 5th vertebral bodies),5 cases occurred in the thoracic spine and 1 case occurred in the sacral spine,21 cases had severe vertebral wedge deformation due to bone destruction,9 cases had slight narrowing of intervertebral space, slight destruction of intervertebral discs,and 1 7 cases had obvious narrowing or narrowing of intervertebral space.7 cases had small paravertebral abscess and 1 6 cases had large paravertebral abscess with flowing phenomenon.Conclusion Vertebral morphology of Brucella spondylitis is basically normal,bone destruction is light and edema range is large,bone hyperplasia is common,slight narrowing (or normal)of intervertebral space occurs in intervertebral disc with less destruction,range of paravertebral abscess is limited.Bone destruction of spinal tuberculosis is heavy and edema range is small,vertebral body is easy to deform with no osteoporosis,significant stenosis (or disappearance)and severe disruption occur in intervertebral disc,paravertebral abscess is large often with flowing phenomenon.