MRI Imaging Comparative Research On Tuberculous Spondylitis,Brucellar Spondylitis And Non-specific Pyogenic Spondylitis

Objective To investigate MRI imaging differences in Tuberculous spondylitis(TBS),Brucellar spondylitis(BS)and non-specific Pyogenic spondylitis(NPS).Methods From January 2010 to December 2017,118 cases were collected,who were hospitalized and definitively diagnosed in the Department of Spinal Orthopedics,General Hospital of Ningxia Medical University,including 60 cases of TBS,40 cases of BS,18 cases of NPS.The clinical data of three groups were collected,such as gender,age,onset time,fever,neurological symptoms,laboratory tests,involved lesion segment,vertebral bone destruction site,epidural abscess,bone destruction type,intervertebral stenosis,intervertebral disc destruction,paravertebral lesions,vertebral collapse,leaping lesions.The description of the measurement data among the three groups was expressed as mean ± standard deviation,and the description of the count data was expressed as the composition ratio(%).The difference of the count data was conducted by using Pearson's Chi-square test and Fisher exact test difference test,and Bonferroni method was used for P value correction in any two groups comparison.P<0.05 indicated a significant difference,speculating MRI imaging differences in TBS,BS and NPS.Results There were statistical differences in MRI imaging between three groups as follows.NPS and BS comparing with TBS,there were statistical differences in bone destruction type(granuloma),intervertebral stenosis(no stenosis,severe stenosis),intervertebral disc destruction(no destruction,diffuse destruction),paravertebral lesions(limited granuloma,invasive abscess)and vertebral collapse(no collapse,severe collapse)(P<0.05).TBS comparing with BS,there were statistical differences in type of bone destruction(localized abscess,inconnective abscess)and intervertebral stenosis(slight stenosis)(P <0.05).As for bone destruction type,limited abscess and inconnective abscess were more common in TBS,but granuloma was more common in NPS and BS.TBS was accompanied with severe intervertebral stenosis,but NPS and BS with rare or mild stenosis.Intervertebral disc destruction was more serious in TBS,and NPS and BS showed no or mild disc destruction.Invasive abscess and limited abscess were more common in TBS,but limited granuloma was more common in NPS and BS.In TBS,vertebral collapse was more serious,and in NPS and BS,vertebral collapse was no or mild.Conclusion Through analyzing MRI characteristics in TBS,BS and NPS,we concluded that MRI has high value in the diagnosis and differential diagnosis of spinal infectious diseases.