CAJ | 학술논문

目的：分析与探讨布鲁菌性脊柱炎与脊柱结核不同的临床影像学特征，提高对布鲁菌性脊柱炎的影像学诊断水平。方法回顾性分析2011年1月至2013年12月，新疆医科大学附属中医医院收治的46例布鲁菌性脊柱炎患者的 X 线片、CT、MRI 影像学资料，与确诊的40例脊柱结核患者的影像学资料进行对比分析。结果布鲁菌性脊柱炎病灶分布于腰椎，其中以 L4患病率最高，骨破坏灶小而多发，多局限于椎体边缘，病灶周围明显增生、硬化，新生骨组织中有新破坏灶形成，椎间盘破坏轻，关节面增生硬化，相邻骨密度增高，少或无椎旁脓肿形成。结核病灶分布于胸腰段，以椎体和椎间盘骨破坏为主，并有死骨形成，椎旁脓肿和骨质疏松变化较常见。结论布鲁菌性脊柱炎和脊柱结核临床影像学特征性表现有助两者的鉴别诊断。
목적：분석여탐토포로균성척주염여척주결핵불동적림상영상학특정，제고대포로균성척주염적영상학진단수평。방법회고성분석2011년1월지2013년12월，신강의과대학부속중의의원수치적46례포로균성척주염환자적 X 선편、CT、MRI 영상학자료，여학진적40례척주결핵환자적영상학자료진행대비분석。결과포로균성척주염병조분포우요추，기중이 L4환병솔최고，골파배조소이다발，다국한우추체변연，병조주위명현증생、경화，신생골조직중유신파배조형성，추간반파배경，관절면증생경화，상린골밀도증고，소혹무추방농종형성。결핵병조분포우흉요단，이추체화추간반골파배위주，병유사골형성，추방농종화골질소송변화교상견。결론포로균성척주염화척주결핵림상영상학특정성표현유조량자적감별진단。
Objective To analyze and discuss the different characteristics of clinical imaging of Brucellar and tuberculous spondylitis,and to improve the diagnostic performance of the image of Brucellar spondylitis.Methods A retrospective analysis at Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University was conducted from January 2011 to December 2013.X-ray,computer tomography (CT)and magnetic resonance imaging (MRI)data of 46 cases of Brucellar spondylitis and 40 cases of tuberculous spondylitis were compared.Results The lumbar spine,especially L4,was usually involved in brucellosis,characterized with multiple small lesions mostly confined to the edge of vertebral body and surrounded by the hyperplasia and sclerosis.New damaged foci were formed in the new bone tissue and intervertebral discs destruction was slight with hyperplasia and sclerosis of articular surface. Few or no paravertebral abscesses were seen.In contrast,thoracic and lumbar spines were more usually affected in tuberculosis featured with destruction of vertebra and intervertebral discs.There could be dead bone formation.Paravertebral abscesses and osteoporosis were frequent.Conclusion The different imaging characteristics of Brucellar and tuberculous spondylitis could favor the differential diagnosis.