MRI Features Of Multi-segment Brucella Spondylitis And Spinal Tuberculosis

Objective: To investigate and analyze MRI imaging and clinical manifestations of multi-segment brucellosis spondylitis and spinal tuberculosis,so as to improve the diagnosis of the two diseases.Methods: The clinical and MRI imaging data of 18 cases of multi-segment brucellosis spondylitis(brucellosis group)and multi-segment spinal tuberculosis(tuberculosis group)confirmed by pathology,laboratory examination and clinical follow-up from January 2012 to December 2015 in our hospital were retrospectively analyzed.Results: Clinical data showed that the incidence rate of male and lower limb pain in the brucellosis group were higher than those in the tuberculosis group,and there was no significant difference between the two groups in clinical symptoms such as fatigue,night sweat and waist and back pain.MRI showed that the incidence of lumbosacral vertebrae,edema of surrounding soft tissues and intervertebral space stenosis(no more than 1/2 of normal)in the brucellosis group were significantly higher than those in the tuberculosis group(P < 0.05).However,the incidence rate of thoracolumbar vertebral flattening,disc destruction,psoas abscess,paravertebral abscess with psoas abscess,paravertebral abscess with spinal canal stenosis,and spinal cord edema in tuberculosis group were significantly higher than those in brucellosis group(p < 0.05).L5/S1 is the most common lumbosacral lesion in the brucellosis group,and most lesions involve the anterior and middle part of the vertebral body.In the tuberculosis group,the anterior,middle and posterior parts of the vertebral bodies are involved.Thoracolumbar spine is the most common lesion,and paravertebral abscesses often have effusion signs.Conclusion: The clinical and MRI signs of the two diseases have certain differences.The diagnosis and differential diagnosis need comprehensive analysis,but the final clinical diagnosis needs to be combined with serological identification.However,imaging and clinical manifestations provide the basis for early diagnosis and differential diagnosis,thusalleviating the patient's condition earlier.