| 张宁,曾献军,何来昌,胡梅东,刘志礼,刘家明,张志宏,陈宣银,舒勇.成人非特异性化脓性脊柱炎MRI分型及其临床意义[J].中国医学影像技术,2019,35(5):740~744 |
| 成人非特异性化脓性脊柱炎MRI分型及其临床意义 |
| MRI typing and clinical significance of adult non-specific pyogenic spondylitis |
| 投稿时间：2018-10-25 修订日期：2019-03-15 |
| DOI：10.13929/j.1003-3289.201810139 |
| 中文关键词: 脊柱炎 骨髓炎 椎间盘炎 磁共振成像 |
| 英文关键词:spondylitis osteomyelitis discitis magnetic resonance imaging |
| 基金项目:江西省科技厅重点研发计划项目（20171BBG70014）。 |
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| 中文摘要: |
| 目的 分析成人非特异性化脓性脊柱炎的MRI表现并进行分型。方法 回顾性分析经病理确诊的34例化脓性脊柱炎患者资料，根据累及脊柱部位及表现进行MRI分型。结果 根据MRI表现分为Ⅰ~Ⅴ型：Ⅰ型化脓性脊椎炎2例，椎体终板出现骨质侵蚀/破坏/水肿，相应椎间盘正常；Ⅱ型化脓性椎间盘炎2例，椎间盘信号异常而邻近椎体未见骨质破坏；Ⅲ型化脓性脊椎-间盘炎27例，同时出现椎体骨质破坏和相邻椎间盘信号异常，其中21例继发硬膜外间隙炎症；Ⅳ型化脓性小关节炎2例，均继发硬膜外间隙炎症及脊膜炎；Ⅴ型复合型1例，同时跨节段发生Ⅲ型和Ⅳ型。结论 MRI可准确显示化脓性脊柱炎受累部位、范围，分型有利于提高对化脓性脊柱炎病理机制的理解和诊断能力。 |
| 英文摘要: |
| Objective To analyze MRI features of non-specific pyogenic spondylitis (PS) in adult, and to propose a new classification of PS. Methods Data of 34 patients with PS confirmed by pathology were retrospectively analyzed. The classification was based on the location of lesions and MRI performances of the involved spine columns. Results According to MRI performances, PS were divided into type Ⅰ-Ⅴ:Type Ⅰ PS (n=2), simple bone erosion/destruction/edema of vertebral endplates without involving corresponding intervertebral disc; type Ⅱ, pyogenic discitis (n=2), simple discitis without involvement of vertebral bodies; type Ⅲ, pyogenic spondylodiscitis (n=27), spondylodiscitis involving both intervertebral disc and adjacent vertebral bodies, and 21 cases with secondary epidural phlegmon; type Ⅳ, pyogenic facet joint infection (n=2), with epidural phlegmon/abscess and leptomeningitis; type Ⅴ, compound type (n=1), simultaneous trans-segments involved type Ⅲ and type Ⅳ together. Conclusion MRI can accurately show the location and extent of the involvement of PS. MRI classification is beneficial to improve understanding of the pathological mechanism and diagnostic ability of PS. |
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