CAJ | 학술논문

目的：探讨动态对比增强磁共振定量成像(dynamic contrast-enhanced MRI，DCE-MRI)技术对布氏杆菌性脊椎炎的鉴别诊断价值。材料与方法16例脊椎病变患者(经临床或手术病理证实：11例布氏杆菌性脊椎炎、2例脊椎椎体转移瘤、3例结核性脊椎炎)行T1WI、T2WI、STIR 及动态对比增强定量检查，分析其形态、信号特点及容积转运参数(Ktrans)与血管外细胞外间隙容积比(Ve)。结果病变累及腰椎最多。布氏杆菌性脊椎炎在MRI上椎体形态多无明显变化，椎体边缘可见小的骨质破坏及骨质增生。病变椎体T1WI呈低信号，T2WI呈低等或等高信号或低等高混杂信号。STIR呈高信号。增强扫描病变椎体明显强化，与周围正常增强的椎体信号类似或更高。各类脊椎病变的Ktrans值与Ve值的差异均有统计学意义(P＜0.05)。结论布氏杆菌性脊椎炎有特征性的磁共振表现，动态对比增强磁共振定量成像对鉴别诊断有重要价值。
목적：탐토동태대비증강자공진정량성상(dynamic contrast-enhanced MRI，DCE-MRI)기술대포씨간균성척추염적감별진단개치。재료여방법16례척추병변환자(경림상혹수술병리증실：11례포씨간균성척추염、2례척추추체전이류、3례결핵성척추염)행T1WI、T2WI、STIR 급동태대비증강정량검사，분석기형태、신호특점급용적전운삼수(Ktrans)여혈관외세포외간극용적비(Ve)。결과병변루급요추최다。포씨간균성척추염재MRI상추체형태다무명현변화，추체변연가견소적골질파배급골질증생。병변추체T1WI정저신호，T2WI정저등혹등고신호혹저등고혼잡신호。STIR정고신호。증강소묘병변추체명현강화，여주위정상증강적추체신호유사혹경고。각류척추병변적Ktrans치여Ve치적차이균유통계학의의(P＜0.05)。결론포씨간균성척추염유특정성적자공진표현，동태대비증강자공진정량성상대감별진단유중요개치。
AbstractObjective:To explore the value ofdynamiccontrastenhanced(DCE) MRI in differential diagnosis of brucellosis spondylitis. Materials and Methods:Sixteen cases with spinal lesions(proved by clinically or histologically: 11 cases were brucellosis spondylitis, 2 cases were vertebral metastases, 3 cases were tuberculous spondylitis) received T1WI, T2WI, STIR and DCE-MRI examination. Morphological and MRI features were analyzed.Results:The lesions were mainly located in the lumbar vertebrae. In the MRI of brucellosis spondylitis, morphology of vertebral body was almost normal. Bone destruction and osteophyte were detected in the rim of vertebral body. The affected vertebral body showed hypointense on T1WI, hypointense, isointense, hyperintense or heterogeneous intense on T2WI and hyperintense on STIR. After injection of contrast media, signal of affected vertebral body was similar to or higher than that of adjacent vertebral body. There were signiifcant differences between the different spinal lesions for Ktrans values and Ve values (P<0.05).Conclusion:Brucellosis spondylitism has some MRI characteristics. DCE-MRI has signiifcant value in the differential diagnosis of brucellosis spondylitis.