Abstract:

Objective To explore the CT features of spinal non-tuberculous mycobacterial disease(spinal NTM disease),in order to improve the diagnosis of spinal NTM disease. Methods A retrospective analysis of 21 patients who diagnosed as spinal NTM disease(study group:11 patients in Guangzhou Chest Hospital and 10 patients in Shenzhen Third People’s Hospital)were collected from Guangzhou Chest Hospital and Shenzhen Third People’s Hospital from January 2015 to December 2018. At the same time,289 patients with spinal tuberculosis who were confirmed by laboratory strain identification and met the inclusion criteria were collected, among them, 53 patients (control group: 39 patients in Guangzhou Chest Hospital and 14 patients in Shenzhen Third People’s Hospital) were selected at the same sex and age to carry out a comparative study.The study compares the CT scanning signs between the two groups,in oder to analyze the CT features of spinal NTM disease. Results The incidence of lesions involving vertebral body ≥3 segments,multi-section (≥2 segments) of vertebral body with multiple forms of destruction without involving the intervertebral disc,osteogenic bone destruction in the study group were 76.19% (16/21), 52.38% (11/21), 57.14% (12/21),respectively,which were 43.40% (23/53), 7.55% (4/53), 9.43% (5/53) in the control group;There were statistically significant differences between the two groups (χ ²=6.489, 16.035, 16.744,respectively;P=0.011,<0.001,<0.001,respectively). The incidence of sequestrum in the area of bone destruction,vertebral collapse, disc destruction, paravertebral abscess, dura and spinal cord compression or invasion in the study group were 42.86% (9/21), 9.52% (2/21), 38.10% (8/21), 33.33% (7/21), 33.33% (7/21),respectively,which were 77.36% (41/53), 49.06% (26/53), 79.25% (42/53), 81.13% (43/53), 75.47% (40/53) in the control group;There were statistically significant differences between the two groups(χ ²=8.170,9.994,11.622,15.681,11.524,respectively;P=0.004,0.002,0.001,<0.001,0.001,respectively). Conclusion The CT scan of spinal NTM disease patients is more likely to see lesions involving vertebral body ≥3 segments,osteogenic bone destruction,multi-section (≥2 segments) of vertebral body with multiple forms of destruction without involving the intervertebral disc;Its CT features are different from those of spinal tuberculosis patients,which can make a contribution for early clinical diagnosis and treatment.

Key words: Spinal diseases, Tuberculosis, Tomography,X-ray computed, Diagnostic imaging, Disease attributes, Diagnosis, differential