弥散张量成像对布氏杆菌脊柱炎椎间盘病变的诊断价值及疗效评估

doi:10.3881/j.issn.1000-503X.10114

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2018, Vol. 40 ›› Issue (4): 519-527.doi: 10.3881/j.issn.1000-503X.10114

• Original Articles • Previous Articles Next Articles

Diffusion Tensor Imaging in Early Diagnosis and Prognostic Prediction of Intervertebral Disc Change in Patients with Brucella Spondylitis

WU Peng¹, ZHANG Yujiao¹, QIN Fang², LIU Lan¹, CUI Shujun¹()

¹Department of Imaging,the First Hospital Affiliated to Hebei North University,Zhangjiakou,Hebei 075000,China
² Department of Orthopedic Surgery,ZhangJiakou Infectious Diseases Hospital,Zhangjiakou,Hebei 075000,China

Received:2017-10-18 Online:2018-08-30 Published:2018-09-08
Supported by:
Supported by Zhangjiakou City Science and Technology Breakthrough Project(1821044D)

Abstract

Abstract:

Objective To explore the value of fractional anisotropy(FA) and apparent diffusion coefficient(ADC) in the early diagnosis of intervertebral disc change in patients with Brucella spondylitis(BS) and in the assessment of BS disc changes after treatment and to further investigate the imaging features of BS in its acute,subacute,and chronic stages. Methods Totally 60 serologically or pathologically confirmed BS patients who were treated in the First Hospital Affiliated to Hebei North University(n=20) or ZhangJiakou Infectious Diseases Hospital(n=40) were enrolled. BS patients were scanned by CT,magnetic resonance imaging,and diffusion tensor imaging,and the FA and ADC values of the disc were measured using the DTI Fiber Trak package. The FA and ADC values were compared in each period and after treatment. Results The ADC value significantly increased and the FA value significantly decreased in different stages(P<0.01). Six months after treatment,the ADC value was significantly lower than the pre-treatment,and the FA value was significantly increased(P<0.01). The ADC value 12 months after treatment for patients in acute or subacute stage and the FA value 12 months after treatment for patients in all stages were significantly different from those in the 6^th month after treatment(P<0.01),and the only exception was that the ADC value in the chronic stage was not significantly different between 12^th and 6^th month after treatment(P=0.089).Conclusion FA and ADC values are more sensitive than conventional MRI sequences in the diagnosis of BS intervertebral disc change and therefore can be used for the early diagnosis and prognostic prediction.

Key words: Brucella spondylitis, diffusion tensor imaging, diffuse weighing imaging, magnetic resonance imaging

CLC Number:

R445.2

WU Peng, ZHANG Yujiao, QIN Fang, LIU Lan, CUI Shujun. Diffusion Tensor Imaging in Early Diagnosis and Prognostic Prediction of Intervertebral Disc Change in Patients with Brucella Spondylitis[J].Acta Academiae Medicinae Sinica, 2018, 40(4): 519-527.

Figures/Tables 8

Fig 1

Fig 2

Fig 3

Fig 4

Fig 5

Table 1

Comparison of intervertebral disc FA and ADC values of BS patients in different observation periods($\bar{x}$±s)"

部位 Location	ADC值ADC value(×10^-4mm²/s)				FA值FA value
部位 Location	对照组 Control group	BS患者急性期 BS patients acute stage	BS患者亚急性期 BS patients subacute stage	BS患者慢性期 BS patients chronic stage	对照组 Control group	BS患者急性期 BS patients acute stage	BS患者亚急性期 BS patients subacute stage	BS患者慢性期 BS patients chronic stage
颈2/3 Cervical 2/3	1.67±0.32	1.77±0.43	1.78±0.41	1.76±0.40	0.58±0.32	0.60±0.29	0.61±0.31	0.59±0.21
颈3/4 Cervical 3/4	1.77±0.44	1.87±0.40	1.88±0.39	1.88±0.41	0.72±0.21	0.54±0.19	0.55±0.20	0.64±0.22
颈4/5 Cervical 4/5	1.65±0.42	1.89±0.52	1.88±0.51	1.81±0.49	0.73±0.22	0.52±0.31	0.55±0.19	0.67±0.24
颈5/6 Cervical 5/6	1.72±0.35	1.94±0.45	1.88±0.38	1.85±0.32	0.69±0.33	0.53±0.21	0.54±0.23	0.67±0.29
颈6/7 Cervical 6/7	1.70±0.33	1.87±0.32	1.86±0.35	1.86±0.31	0.77±0.18	0.75±0.20	0.77±0.19	0.78±0.21
颈7/胸1 Cervical 7/thoracic 1	1.73±0.41	1.75±0.39	1.76±0.44	1.74±0.29	0.75±0.15	0.74±0.14	0.76±0.17	0.76±0.19
胸1/2 Thoracic 1/2	1.63±0.22	1.69±0.30	1.64±0.27	1.65±0.33	0.65±0.23	0.63±0.32	0.64±0.28	0.65±0.19
胸2/3 Thoracic 2/3	1.67±0.31	1.69±0.32	1.68±0.31	1.68±0.29	0.70±0.30	0.66±0.29	0.69±0.28	0.70±0.29
胸3/4 Thoracic 3/4	1.72±0.41	1.73±0.39	1.72±0.40	1.72±0.23	0.69±0.29	0.67±0.28	0.68±0.27	0.69±0.26
胸4/5 Thoracic 4/5	1.70±0.43	1.71±0.33	1.71±0.30	1.71±0.29	0.70±0.21	0.68±0.25	0.69±0.24	0.70±0.19
胸5/6 Thoracic 5/6	1.72±0.44	1.90±0.32	1.92±0.33	1.75±0.29	0.68±0.23	0.66±0.24	0.67±0.24	0.67±0.30
胸6/7 Thoracic 6/7	1.88±0.21	1.89±0.22	1.87±0.42	1.88±0.23	0.71±0.33	0.68±0.31	0.69±0.35	0.70±0.37
胸7/8 Thoracic 7/8	1.78±0.33	1.90±0.32	1.89±0.22	1.80±0.34	0.80±0.21	0.65±0.25	0.75±0.19	0.79±0.22
胸8/9 Thoracic 8/9	1.69±0.45	1.88±0.32	1.87±0.42	1.83±0.24	0.79±0.22	0.67±0.23	0.70±0.20	0.75±0.24
胸9/10 Thoracic 9/10	1.73±0.34	1.98±0.22	1.96±0.34	1.90±0.32	0.75±0.31	0.59±0.21	0.64±0.23	0.71±0.29
胸10/11 Thoracic 10/11	1.78±0.29	1.87±0.34	1.86±0.23	1.82±0.31	0.76±0.29	0.56±0.23	0.63±0.25	0.68±0.24
胸11/12 Thoracic 11/12	1.69±0.34	1.88±0.21	1.85±0.23	1.79±0.34	0.73±0.31	0.60±0.29	0.65±0.23	0.69±0.25
胸12/腰1 Thoracic 12/lumbar1	1.78±0.22	1.89±0.24	1.87±0.26	1.84±0.35	0.69±0.29	0.61±0.23	0.64±0.25	0.67±0.24
腰1/2 Lumbar 1/2	1.73±0.32	1.80±0.32	1.81±0.29	1.74±0.33	0.77±0.33	0.64±0.32	0.69±0.11	0.75±0.26
腰2/3 Lumbar 2/3	1.69±0.32	1.75±0.29	1.74±0.30	1.70±0.34	0.76±0.19	0.63±0.22	0.69±0.19	0.75±0.32
腰3/4 Lumbar 3/4	1.73±0.23	1.89±0.21	1.87±0.30	1.80±0.29	0.77±0.31	0.53±0.33	0.64±0.34	0.70±0.30
腰4/5 Lumbar 4/5	1.70±0.33	1.85±0.23	1.84±0.34	1.79±0.29	0.78±0.29	0.60±0.23	0.66±0.25	0.75±0.33
腰5/骶1 Lumbar 5/sacral 1	1.72±0.23	1.86±0.33	1.83±0.24	1.80±0.25	0.77±0.24	0.64±0.11	0.67±0.25	0.72±0.26
F	3.527	175.500	160.640	174.200	5.762	83.330	79.550	69.560
P	0.078	0.001	0.002	0.001	0.069	0.000	0.001	0.002

Table 1

Fig 6

Table 2

References 13

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分期 Phase	ADC 值 ADC value
分期 Phase	治疗前 Before treatment	治疗后6个月 6 months after treatment	治疗后12个月 12 months after treatment	P1	P2	P3
急性期Acute stage(n=15)	1.83±0.33	1.71±0.14	1.68±0.13	0.007	0.021	0.006
亚急性期Subacute stage(n=8)	1.81±0.23	1.66±0.18	1.65±0.19	0.005	0.007	0.013
慢性期Chronic stage(n=13)	1.79±0.34	1.65±0.18	1.65±0.17	0.002	0.012	0.089
分期 Phase	FA值 FA value
分期 Phase	治疗前 Before treatment	治疗后6个月 6 months after treatment	治疗后12个月 12 months after treatment	P1	P2	P3
急性期Acute stage(n=15)	0.62±0.21	0.73±0.19	0.75±0.22	0.023	0.008	0.025
亚急性期Subacute stage(n=8)	0.64±0.18	0.74±0.18	0.76±0.21	0.019	0.002	0.034
慢性期Chronic stage(n=13)	0.67±0.23	0.74±0.22	0.77±0.23	0.031	0.043	0.044

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Diffusion Tensor Imaging in Early Diagnosis and Prognostic Prediction of Intervertebral Disc Change in Patients with Brucella Spondylitis

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