| BackgroundNowadays tuberculosis is an ancient and still common disease, caused by mycobacteria, which can involve many systems such as respiratory system, musculoskeletal system and urinary system. Spinal tuberculosis is the most common infection among the tuberculosis outside of pulmonary tuberculosis. The morbidity of spinal tuberculosis is amount to one percent of tuberculosis and fifty percent of musculoskeletal system tuberculosis. According to the world health organization report, the morbidity of tuberculosis in our country occupies second place in the world, which has cause serious burden on individual and country. Tuberculosis spindylitis has been increasing in developing countries due to the poor economic and hygienic status, and the same condition has also been appearing recently in developed countries because of antibiotic resistance. Due to the insidious and chronic symptom in the Tuberculosis spondylitis, misdiagnosis and delayed diagnosis is often occurred, which mybe introduce some serious complications such as high or low paraplegia, spine deformity. These complications seriously affect the patients’life equality. Brucellosis is zoonotic disease caused by brucella, Common in northwest China, Tibet Plateau and so on, spreading through the animal such as cattle, goats and dog. Brucella can involved multiorgan systems, such as urinary system, digestive system, musculoskeletal system and hemopoietic system. Brucellar spondylitis is common complication of the brucellosis. With the increase consumption of the dairy production, the morbidity of brucellar spondylitis is rising. There are many resemble characteristic between the tuberculosis spondylitis and brucellar spondylitis in the clinic symptoms. Delayed and misdiagnosis can cause serious spinal complications. This study focus on the typical characteristic between the tuberculous spondylitis and brucellar spondylitis on MR images in order to explore the differences, which maybe induce a decrease in the misdiagnosis and paraplegia and deformation.ObjectivesBoth the tuberculous spondylitis (TS) and the brucellar spondylitis (BS) can cause deformity and permanent neurologic deficiency without prompt diagnosis and treatment. But the distinguish diagnosis is very difficult. The aim of this study is to investigate the differences between the tuberculous spondylitis and the brucellar spondylitis on MRI images.Methods18 patients with tuberculosis spondylitis and 26 with brucellar spondylitis were included in this study. MRI images were obtained and analyzed respectively. For statistical analysis, the chi-square test was performed.ResultsThere were statistically significant differences between the TS and BS on the MRI images:1.subligamentous spread to three or more vertebral levels (TS 54%[7/13] vs BS 8%[1/12]) 2.subligamentous spread to less than three vertebral levels(23% [3/13] vs 58%[7/12]) 3.thoracic spine involvement (50% [9/18] vs 4%[1/26]) and lumber spine involvement(22%[4/18] vs 77%[20/26]) and 4.abnormal signal in vertebral disc on T2-weighted images(33%[7/21] vs 85%[30/35]) 5.focal or fan-shape hyperintense signal on middle Sagittal fat-suppressed weighted images(14% [7/50] vs 50%[31/62]), especially the fan-shape hyperintense signal (0%[0/50] vs 23% [14/62]) 6.spinal kyphosis(22%[11/50] vs 3%[2/62]) 7.vertebral collapse(42% [21/50] vs 2%[1/62]) 8.peridiscal bone destruction(22%[11/50] vs 44%[27/62]) 10.Psoas abscesses(6%[3/50] vs 0%[0/62]).ConclusionsMRI is a sensitive imaging technique and can clearly define the different features between the TS and BS, which should be the first choice of imaging in the diagnosis of spondylodiscitis. |
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