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寻找MRI特征,以避免在临床上怀疑持续或复发性脊髓骨质炎时需要重复脊髓活检
Stephany Barreto1, Salil Sharma2, Gaurav Cheraya3
1SUNY Upstate University Hospital, Syracuse, NY 13210, USA.
Polish journal of radiology
|May 26, 2023
概括
磁共振成像 (MRI) 可以帮助区分脊柱感染与机械骨损伤. 软组织变化的恶化,而不是骨的破坏,是复发感染的关键指标,有可能避免重复活检.
科学领域:
- 放射学 放射学是一门学科.
- 整形外科 整形外科 整形外科
- 传染性疾病 传染性疾病
背景情况:
- 在传染性脊髓炎中区分复发性脊柱感染与机械因素是具有挑战性的.
- 可能需要重复脊柱活检,但可能是侵入性的,并产生负面结果.
- 磁共振成像 (MRI) 对于监测治疗反应和疾病进展至关重要.
研究的目的:
- 确定特定的MRI特征,区分骨损伤与持续/反复的脊柱感染以及机械原因.
- 通过提高诊断准确度,减少重复脊柱活检的需要.
主要方法:
- 对18岁以上患有传染性脊髓炎和至少两次脊柱干预的患者进行的MRI研究的回顾性分析.
- 评估MRI特征,包括脊椎体变化,准脊椎/表皮收藏,骨髓信号和磁盘异常.
- 核磁共振成像结果与临床结果的相关性.
主要成果:
- 椎及外周软组织变化的恶化是复发/持久脊柱感染的显著预测因素 (p<0.05).
- 恶化的脊椎体/盘破坏和异常的骨髓/盘信号并不可靠地表明感染复发.
- 在疑似复发的情况下,MRI检测骨变化的结果可能会误导.
结论:
- 在MRI上软组织的变化比骨质变化更能表明复发的脊柱感染.
- 仅仅依赖于MRI上恶化的骨损坏可能会导致不必要的重复活检.
- 将MRI软组织发现与临床检查和炎症标志物的整合改善了复发性传染性脊髓炎的诊断准确性.
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