Diagnosis And Prognosis Evaluation Of Brucellosis Spondylitis By ⁹⁹mTc-MDP SPECT/CT Combined With MRI

Objective:⁹⁹mTc-MDPSPECT/CT imaging can reflect the characteristics of bone metabolism and abnormal changes of CT in different periods after bone injury in human body,and can diagnose BS and evaluate the degree and prognosis of bone injury in BS.In this study,⁹⁹mTc-MDP SPECT/CT imaging was used to observe the metabolic function changes and structural changes of bone in the focus segment in different periods of BS patients.Combined with MRI examination and laboratory tests,according to the different characteristics of bone imaging in different periods,the value of ⁹⁹mTc-MDP SPECT/CT in diagnosis and prognosis evaluation of BS was discussed.Materials and methods:The patients were selected from the affiliated hospital of Inner Mongolia Medical University and the Inner Mongolia Center for Disease Control and Prevention from January 2018 to October 2020,who were diagnosed as Brucellosis after positive blood culture results of Imbru,and found to have symptoms of low back pain or nerve injury through patient complaints and physical examination of doctors,but did not implement any medical intervention.Collect the medical history,symptoms and signs,laboratory tests,MRI examination and ⁹⁹mTc-MDP SPECT/CT examination before treatment,give these patients a unified treatment plan,and review the symptoms and signs,laboratory tests,MRI examination and ⁹⁹mTc-MDP SPECT/CT examination three months later.Finally,30 cases were followed up on time after 3 months,including 21 male patients and 9 female patients.SPSS26.0 statistical software was used to analyze the data obtained.Chi-square test was used to compare the difference between the two methods in diagnosing BS patients and locating the number of vertebral bodies.T-test was used to compare the difference between ⁹⁹mTc-MDP SPECT/CT before and after treatment,so as to explore the value of ⁹⁹mTc-MDP SPECT/CT in diagnosis and prognosis evaluation of BS.Results:Finally,30 patients were enrolled,among which 25 patients were diagnosed as BS,5 patients were diagnosed as brucellosis but not BS,and 55 vertebral bodies were detected.25 patients with BS were diagnosed by MRI and 25 patients with BS were diagnosed by⁹⁹mTc-MDP SPECT/CT.The ⁹⁹mTc-MDP SPECT/CT examination located 52 infected vertebral bodies,and MRI examination located 55 infected vertebral bodies.The infected vertebral bodies included 1 cervical vertebral body（1.8%）,4 thoracic vertebral bodies（7.3%）and 50 lumbar vertebral bodies（90.9%）.After statistical analysis,the results are as follows:⁹⁹mTc-MDP SPECT/CT examination and MRI examination performed Chi-square test analysis on the diagnosis of BS,and the diagnosis results were equal and had no statistical significance（P=1>0.05）;The ⁹⁹mTc-MDP SPE CT/CT examination and MRI examination showed that MRI examination was higher than ⁹⁹mTc-MDP SPECT/CT examination,but the difference was not statistically significant（P=0.84>0.05）.In addition,for monitoring the disease and evaluating the prognosis,the data measured by ⁹⁹mTc-MDP SPECT/CT before and after treatment by semi-quantitative analysis of nuclides in the lesion site are different by t-test,but the difference is not statistically significant（t=1.436,P>0.05）.Conclusion:1.there is no significant difference in the diagnosis of BS diseases between the two examination techniques.however,the detection rate of ⁹⁹mTc-MDP SPECT/CT examination on the vertebral bodies of BS lesions is lower than that of MRI examination,and it is inferior in examination time,cost,radiation harm to the body and so on.2.⁹⁹mTc-MDP SPECT/CT examination is less valuable than MRI examination in monitoring the condition and evaluating the prognosis of BS for three months.3.⁹⁹mTc-MDP SPECT/CT can be used as a supplementary examination for BS patients after MRI examination,and can be used to screen some asymptomatic occult lesions.4.⁹⁹mTc-MDP SPECT/CT can be used as the first choice for BS patients with MRI contraindications.