目的 研究脊柱结核与脊柱炎的 MRI影像鉴别价值。方法 将我院2009年 5月至2014年7月收治的40例脊柱结核患 者、34例布鲁杆菌脊柱炎患者纳入研究范 围。对其一般资料与病历资料行回顾性分 析。由两位经验丰富的影像诊断医师共同 比较两组MRI影像表现与病变特征。结果 40例脊柱结核患者中，35例表现为腰椎病 变，27例前侧椎体破坏，16例呈椎间盘弥 散性破坏，24例出现重度椎间隙狭窄，另 有9例出现椎旁脓肿。34例布鲁杆菌脊柱 炎患者中，28例为腰椎病变，椎体后侧破 坏20例，31例伴随骨质增生，15例为椎间 盘局部性破坏。结论 脊柱结核与布鲁杆 菌脊柱炎的MRI表现有一定差异性，临床 可根据二者影像学特征，结合实验室检查 等手段准确鉴别。

Objective To study the value of MRI in the differential diagnosis of spinal tuberculosis and spondylitis. Methods 40 cases of patients with spinal tuberculosis and 34 cases with Brucella spondylitis who were treated in our hospital between May 2009 and July 2014 were enrolled in the study. The general data and medical records were retrospectively analyzed. The MRI findings and pathological features were compared by two experienced imaging diagnostic physicians between the two groups. Results In 40 cases with spinal tuberculosis, 35 cases manifested as lumbar diseases, 27 cases as anterior vertebral destruction, 16 cases as intervertebral disc diffuse destruction, 24 cases as severe intervertebral space stenosis, and another 9 cases as paravertebral abscess. Among 34 cases with Brucella spondylitis, 28 cases were with lumbar diseases, 20 cases with posterior vertebral destruction, 31 cases with hyperplasia and 15 cases with local intervertebral disc destruction. Conclusion The MRI findings of spinal tuberculosis and Brucella spondylitis are different. In clinic, accurate differential diagnosis can be made according to their imaging findings, combined with the laboratory examination and other means.