中文摘要：

目的探讨动态对比增强MRI（DCE-MRI）定量分析在布氏杆菌脊柱炎诊断及早期诊断中的价值。方法回顾性分析56例布氏杆菌病患者，男32例，女24例，平均年龄（49±3）岁。入组标准：所有患者临床均诊断为布氏杆菌脊柱炎,且实验室检查血清凝集实验检测滴度1∶100〉（＋＋），琥红平板凝集实验〉（＋＋），酶联免疫吸附实验检测特异性抗体IgM/IgG （＋）。排除标准：（1）孕妇或哺乳期妇女；（2）有MRI扫描禁忌的患者；（3）患有脊柱结核、骨髓瘤等其他脊柱疾病的患者；（4）累及颈椎、胸椎及腰5椎体以外的患者。将患者分为早期病变组：腰背痛时间〈1个月，酶联免疫吸附实验检测特异性抗体IgM阳性，IgG阴性，常规MRI检查未见椎体病变；病变组：腰背痛时间〉3个月，酶联免疫吸附实验检测特异性抗体IgG阳性、IgM阴性，常规MRI检查可见明显病变。两组患者均行常规MRI及DCE-MRI检查，在灌注参数图上测量病变组患者的病变椎体与正常椎体的容积转运参数（Ktrans）、速率常数（Kep）、血管外细胞外容积分数（Ve）、血浆容积分数（Vp）值并进行自身对照。本研究中，病变组病变椎体选择腰5椎体，正常椎体选择腰1椎体（与病变椎体相差3个椎体，常规MRI未见侵犯）；早期病变组选择腰5椎体。应用配对t检验（正态分布资料）比较病变椎体与正常椎体以上参数的差异；应用独立样本t检验分别比较早期病变组与病变组的正常椎体及病变椎体上述参数的差异。结果常规MRI扫描56例患者中，病变累及腰5及骶1椎体32例、椎体未见明确病变24例。病变组椎体Ktrans、Kep、Ve、Vp值分别为：（0.856±0.539）ml/min、（1.482±0.711）ml/min、0.542±0.267、0.034±0.017；正常椎体分别为（0.315±0.298）ml/min、（0.713±0.548）ml/min、0.358±0.259、0.056±0.031，两组之间差异均有统计学意?

英文摘要：

ObjectiveTo explore the value of dynamic contrast-enhanced （DCE）. MRI in the early diagnosis of brucellosis spondylitis.MethodsFifty-six patients （24 female and 32 male） with Brucellosis with average age of （49±3） years were retrospectively analyzed. Inclusion criteria： The patients with clinically diagnosed brinell coli spondylitis, drops of serum agglutination test degree 1∶100〉（＋＋）, Hu〉red plate agglutination test （＋＋）, enzyme-linked immunosorbent assay to detect specific antibody IgG/IgM （＋）. Exclusion criteria： Pregnant and lactating women, patients with MRI examination contraindications and spinal tuberculosis, myeloma or other spinal disease, patients with the cervical, thoracic and lumbar 5 vertebral body involvement. The patients were classified into early lesion group and lesion group. Early lesion group was defined as low back pain less than a month, enzyme-linked immunosorbent assay positive IgM and negative IgG results, and no abnormality in conventional MR imaging, while lesion group was defined as low back pain for longer than 3 months, enzyme-linked immunosorbent assay positive IgG and negative IgM and marked lesion in conventional MR imaging. All the patients conducted with conventional MRI and DCE-MRI scan. The differences of the Ktrans, Kep, Ve and Vp between the vertebral lesions, early lesions of vertebral body and normal tissues were measured and compared.ResultsThe values of Ktrans, Kep, Ve and Vp were significantly different between the vertebral lesions [（0.856±0.539） ml/min, （1.482±0.711） ml/min, 0.542±0.267, 0.034±0.017] and normal tissues [（0.315±0.298） ml/min, （0.713±0.548） ml/min, 0.358±0.259, 0.056±0.03] （all P〈0.05）. The values of Ktrans,Kep and Vp were significantly different between the early lesions of vertebral body and normal tissues （all P〈0.05）, while no difference was found for Ve between the two groups （P〉0.05）.ConclusionDCE-MRI quantitative analysis plays a role in the early diagnosis o