MRI and pathological discrimination of early pyogenic spondylitis from brucella spondylitis

doi:10.3969/j.issn.2095-4344.2014.04.002

Abstract

Abstract:

BACKGROUND: Pathological examination and MRI have been widely used in clinic, but their combination is rarely reported in discrimination of early spine infections.
OBJECTIVE: To determine the accuracy of pathology and MRI for discrimination between early pyogenic spondylitis and brucella spondylitis.
METHODS: Twenty-two patients with pyogenic spondylitis and 20 patients with brucella spondylitis who had CT-guided percutaneous biopsy and MRI of the spine were retrospectively reviewed. Pathological observations included structure and activity of bone lesions, tissue cells and their main components; MRI observations included signal and sign changes at lesion sites. Statistical analysis was performed with the chi-square test.
RESULTS AND CONCLUSION: The patients with pyogenic spondylitis had a significantly higher incidence of pathological and MRI findings as follows (P < 0.05): neutrophil infiltration; intervertebral disc abnormal signal, location of vertebral body lesions anterior+posterior, obviously shape change in the vertebral body, paraspinal abnormal signal, presence of intraosseous or paraspinal abscess. Pathological and MRI examination was accurate for early differentiation of pyogenic spondylitis from brucella spondylitis.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: pathology, magnetic resonance imaging, spondylitis, early diagnosis, diagnosis, differential

CLC Number:

R318

Liu Tao, Sun Jian-min, Cui Xin-gang, Jiang Zhen-song. MRI and pathological discrimination of early pyogenic spondylitis from brucella spondylitis[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(4): 499-504.

Figures/Tables 5

2.4 MRI结果病变部位：2组患者颈、胸、腰、骶椎分布差异无显著性意义(P > 0.05)(表2)。 MRI征象：在下列征象中，化脓性脊柱炎组发生率明显高于布氏杆菌脊柱炎组，且差异有显著性意义(P < 0.05)：椎间盘明显异常信号(化脓性脊柱炎组64%，布氏杆菌脊柱炎组35%)，椎体病变位置椎体前+后方(化脓性脊柱炎组77%，布氏杆菌脊柱炎组45%)，病变椎体形态明显变化(化脓性脊柱炎组59%，布氏杆菌脊柱炎组25%)，椎旁软组织异常信号(化脓性脊柱炎组73%，布氏杆菌脊柱炎组35%)，骨内或椎旁脓肿形成(化脓性脊柱炎组55%，布氏杆菌脊柱炎组25%)。在下列征象中，布氏杆菌脊柱炎组发生率明显高于化脓性脊柱炎组，且差异有显著性意义(P < 0.05)：椎间盘无明显异常信号(布氏杆菌脊柱炎组75%，化脓性脊柱炎组36%)，椎体病变位置椎体前方(布氏杆菌脊柱炎组55%，化脓性脊柱炎组14%)，椎体形态无明显变化(布氏杆菌脊柱炎组75%，化脓性脊柱炎组41%)，无明显椎旁软组织异常信号(布氏杆菌脊柱炎组65%，化脓性脊柱炎组27%)，无骨内或椎旁脓肿形成(布氏杆菌脊柱炎组85%，化脓性脊柱炎组46%)。在下列征象中，化脓性脊柱炎组与布氏杆菌脊柱炎组发生率差异无显著性意义(P > 0.05)：T1WI低信号(化脓性脊柱炎组86%，布氏杆菌脊柱炎组90%)，T2WI高信号(化脓性脊柱炎组68%，布氏杆菌脊柱炎组75%)，病变位置位于椎体后方(化脓性脊柱炎组9%，布氏杆菌脊柱炎组10%)，硬膜外脓肿形成(化脓性脊柱炎组13.6%，布氏杆菌脊柱炎组10%)，无硬膜外脓肿形成(化脓性脊柱炎组86%，布氏杆菌脊柱炎组90%)，牵涉椎体数≥3个(化脓性脊柱炎组9%，布氏杆菌脊柱炎组5%)，牵涉椎体数≤2个(化脓性脊柱炎组91%，布氏杆菌脊柱炎组95%)(表2，图2，3)。"

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