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目的通过不同的椎体终板破坏分型分析布鲁菌性脊柱炎(BS)与结核性脊柱炎(TS)的骨质破坏的形态学差异。方法对37例BS和35例TS患者术前均行脊柱MR检査。将椎体终板骨质破坏按形态学特征分为5型(边缘型、中央1型、中央2型、混合型、完全型),对BS及TS的MRI图像进行分型,并将观察结果进行统计学分析。结果 BS中央1型椎体终板骨质破坏的发生率明显高于TS(P<0.001);TS混合型椎体终板骨质破坏的发生率明显高于BS(P<0.001);BS和TS边缘型、中央2型、完全型发生率的差异无统计学意义(P均>0.05)。BS和TS病变部位及MR其他观察结果(包括椎体T1WI低信号、T2WI脂肪抑制高信号、椎间隙狭窄、椎间盘信号异常)差异均无统计学意义(P均>0.05)。结论 BS和TS在病变椎体终板骨质破坏的形态学上存在差异,有助于两者在MRI影像上的鉴别诊断。
OBJECTIVE: To analyze the morphological differences of the bone destruction of brucellic spondylitis (BS) and tuberculous spondylitis (TS) by different types of vertebral endplate destruction. Methods 37 cases of BS and 35 cases of TS patients underwent preoperative spinal MR examination. The vertebral endplate osteolysis was divided into 5 types (edge type, central type 1, central type 2, mixed type, complete type) according to the morphological characteristics. The MRI images of BS and TS were classified, and the observation results Statistical analysis. Results The incidence of end-plate osteolysis in type-1 central vertebral body was significantly higher than that in TS (P <0.001). The incidence of end-plate osteolysis in TS-type vertebral bodies was significantly higher than that in BS (P <0.001) TS edge type, central type 2, the complete type of incidence was no significant difference (P all> 0.05). There was no significant difference between BS and TS lesions and MR findings (including low T1WI signal, high T2WI fat suppression signal, intervertebral space stenosis and abnormal disc signal) (all P> 0.05). Conclusion The morphological differences between BS and TS in the destruction of vertebral endplate are helpful to the differential diagnosis between the two.