The value of MRI in differentiating Modic type Ⅰspinal degenerative changes from early spondylitis in patients with brucellosis

doi:10.19871/j.cnki.xfcrbzz.2024.06.005

Abstract

Abstract: Objective To explore the application value of MRI in the differential diagnosis of early spondylitis in brucellosis patients and Modic typeⅠ spinal degeneration, and to provide imaging reference for the differential diagnosis of the two. Method Fifteen patients diagnosed with early brucellosis spondylitis admitted to the People's Hospital of Inner Mongolia Autonomous Region from January 2020 to May 2024 were selected as the BS group, and 17 patients with lumbar Modic type Ⅰ spinal degeneration were selected as the MⅠ group. All patients underwent MRI examination. The morphology, signal, bone change and enhanced image pattern of the diseased vertebral body and adjacent discs of the two groups were compared respectively. Result The 15 patients in BS group had 28 vertebral body lesions, with an average age of 47.88 years. A total of 27 vertebral bodies were involved in 17 patients in MⅠ group with an average age of 53.60 years. Vertebrae prone to lesions in BS group: L4, accounting for 28.57% (8/28); The lesions were mainly characterized by hypointense on T₁WI (13/28, 46.43%), clear boundary on T₂WI (24/28, 85.71%) and discontinuous end-plate contour on T₁WI (24/28, 85.71%). No positive DWI claw sign was found. Lesion enhancement 100% (17/17); 10.71% (3/28) of the vertebral bodies had bone destruction. Most lesions were fan-shaped or stripe-shaped (23/28, 82.14%). T₂WI hyperintensity of intervertebral disc was 83.33% (15/18). In MⅠ group, the lesion was L5, accounting for 33.33% (9/27), and the lesion was mainly iso-hypointensity such as T₁WI (18/27, 66.67%). The incidence of hyperintense in T₁WI was 11.11% (3/27). The main lesions were blurred boundary on T₂WI (18/27, 66.67%) and continuous endplate contour on T₁WI (22/27, 81.48%). DWI claw positive 100% (7/7); Lesion enhancement 100% (7/7); Some vertebrae had bone destruction 14.81% (4/27); Segment or strip shape of the lesion 62.96% (17/27). Intervertebral disc T₂WI hyperintense accounted for 20.00% (3/15). Conclusion :DWI claw sign is positive, indicating MⅠ clearly. T₁WI endplate contour is continuous, MⅠ possibility is high; Involved intervertebral disc T2WI hyperintense, BS is more likely; T₁WI hyperintense appeared in the lesion, indicating MⅠ. The above features are significant for the differential diagnosis of early spondylitis in brucellosis patients and ModicⅠspinal degeneration. Lesion morphology and enhancement have little value in the differential diagnosis of the two, and are not recommended as differential indicators.

Key words: Brucellosis, Spondylitis, Modic typeⅠspinal degeneration, Magnetic resonance imaging

CLC Number:

R378.5

Li Junlin, Ding Haitao, Wang Lina, Yin Songtao, Zhao Nan. The value of MRI in differentiating Modic type Ⅰspinal degenerative changes from early spondylitis in patients with brucellosis[J]. Electronic Journal of Emerging Infectious Diseases, 2024, 9(6): 26-31.

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