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磁共振成像在脊柱外骨关节布鲁氏菌病诊断中的价值

The value of magnetic resonance imaging in the diagnosis of extraspinal osteoarticular brucellosis.

作者信息

Xiong Chunmei, Zhao Yan, Han Mei, Li Jianzhi

机构信息

Department of Radiology, Shandong Provincial Public Health Clinical Center Affiliated to Shandong University, Jinan City, Shandong Province, China.

出版信息

Medicine (Baltimore). 2025 Aug 15;104(33):e43923. doi: 10.1097/MD.0000000000043923.

DOI:10.1097/MD.0000000000043923
PMID:40826679
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12366982/
Abstract

To explore the value of multimodal magnetic resonance imaging (MRI) in diagnosing extraspinal osteoarthritic brucellosis and improve its diagnostic accuracy. Thirty-nine patients diagnosed with brucellosis with corresponding joint pain admitted to our hospital from December 2020 to November 2021 were retrospectively analyzed as study subjects, and all of them underwent MRI, diffusion-weighted imaging, and gadoterate meglumine to observe the MRI imaging features of extraspinal osteoarthritic brucellosis and the affected joints. In order to analyze the diagnostic value of MRI for extraspinal osteoarthritic brucellosis. The shoulder, sacroiliac, and knee joints were the most frequent sites of extraspinal osteoarthritic brucellosis, all accounting for 23.1% of cases, followed by 15.4% of hip joints. The overall lesions showed plaque-like, worm-like, and irregular-shaped damage according to the analysis of the clinical manifestations. Meanwhile, sclerosis at the edges of the lesions was characterized by long T1 and prolonged T2 signal abnormality and high signal in fat suppression-T2-weighted imaging. Overall swelling of the soft tissues in the vicinity of the joint, with long T1 and long T2 signal abnormalities and high signal on fat suppression-T2-weighted imaging. For abscess formation, by analyzing the joint cavity of the patient, the liquid signal shadow of T2 could be seen, and the lesion area showed noticeable uneven sheet enhancement in the enhanced scan. Extraspinal osteoarthritic brucellosis has specific characteristics in MRI, and MRI has significant clinical value in the diagnosis, differentiation, and evaluation of the therapeutic efficacy of this disease.

摘要

探讨多模态磁共振成像(MRI)在诊断脊柱外骨关节炎型布鲁氏菌病中的价值,提高其诊断准确性。回顾性分析2020年12月至2021年11月我院收治的39例诊断为布鲁氏菌病且伴有相应关节疼痛的患者作为研究对象,所有患者均接受了MRI、扩散加权成像及钆喷酸葡胺检查,以观察脊柱外骨关节炎型布鲁氏菌病及受累关节的MRI成像特征,分析MRI对脊柱外骨关节炎型布鲁氏菌病的诊断价值。脊柱外骨关节炎型布鲁氏菌病最常累及的部位为肩部、骶髂关节和膝关节,各占病例数的23.1%,其次为髋关节,占15.4%。根据临床表现分析,总体病变表现为斑块状、蠕虫状及不规则形破坏。同时,病变边缘硬化在T1加权像呈长T1信号、T2加权像呈信号延长及脂肪抑制T2加权像呈高信号。关节周围软组织整体肿胀,在T1加权像和T2加权像呈信号延长,脂肪抑制T2加权像呈高信号。对于脓肿形成,通过分析患者关节腔,可见T2液体信号影,增强扫描病变区域呈明显不均匀片状强化。脊柱外骨关节炎型布鲁氏菌病在MRI上具有特异性表现,MRI在该病的诊断、鉴别诊断及治疗疗效评估方面具有重要临床价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4887/12366982/435095c7ee50/medi-104-e43923-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4887/12366982/5493e21e2cfb/medi-104-e43923-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4887/12366982/96bd486bfe0d/medi-104-e43923-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4887/12366982/435095c7ee50/medi-104-e43923-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4887/12366982/5493e21e2cfb/medi-104-e43923-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4887/12366982/96bd486bfe0d/medi-104-e43923-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4887/12366982/435095c7ee50/medi-104-e43923-g003.jpg

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本文引用的文献

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Microbiological Laboratory Diagnosis of Human Brucellosis: An Overview.人类布鲁氏菌病的微生物学实验室诊断:概述
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Neurobrucellosis: Brief Review.神经布鲁菌病:简要综述。
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Seroprevalence of Bovine Brucellosis in Ethiopia: Systematic Review and Meta-Analysis.埃塞俄比亚牛布鲁氏菌病的血清流行率:系统评价与荟萃分析
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Etiopathogenesis of sacroiliitis: implications for assessment and management.骶髂关节炎的病因发病机制:对评估和管理的启示
Korean J Pain. 2020 Oct 1;33(4):294-304. doi: 10.3344/kjp.2020.33.4.294.
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Brucellosis in China: history, progress and challenge.中国布鲁氏菌病:历史、进展与挑战。
Infect Dis Poverty. 2020 May 24;9(1):55. doi: 10.1186/s40249-020-00673-8.
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Brucellosis in the Middle East: Current situation and a pathway forward.中东地区的布鲁氏菌病:现状与前进道路。
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Different Clinical Manifestations of Human Brucellosis in Pregnant Women: A Systematic Scoping Review of 521 Cases from 10 Countries.孕妇感染布鲁氏菌病的不同临床表现:对来自10个国家的521例病例的系统综述
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