Abstract
OBJECTIVE: To explore the X-ray, CT, and MRI imaging features of Brucellar spondylodiscitis (BS) across different stages and evaluate their diagnostic value. METHODS: Retrospective analysis of imaging features in 137 BS patients (early stage: 40; advanced: 52; recovery: 45) classified by the 2023 Chinese Medical Association Consensus. Diagnostic performances of X-ray, CT, and MRI were compared. RESULTS: Lumbar involvement predominated (98.5%), with 73.7% single-segment cases. X-ray missed 90% of early-stage BS but detected intervertebral stenosis/bone destruction better in advanced/recovery stages (P<0.05). CT excelled in identifying bone destruction (83.9%), sequestration (5.1%), and fractures (6.6%). MRI detected granulomas (85.4%) and abscesses (3.6%) effectively, especially granulomas in advanced-stage (p < 0.05, compared with early stage and recovery stage). CT+MRI synergistically improved staging accuracy for early/advanced BS. CONCLUSION: CT and MRI are critical for BS staging, with combined use recommended to minimize misdiagnosis and guide treatment.