Background Brucellar spondylitis (BS) and tuberculous spondylitis (TS) which cause initial bacteremia and show granulomatous lesions are the two leading types of spinal inflammatory. BS is easy to miss or maybe misdiagnosed as TS. Our purpose differentiates brucella spondylitis (BS) from tuberculous spondylitis (TS) in conventional MR imaging and MR T2 mapping.Methods We performed on 26 BS and 27 TS patients in conventional MR imaging and MR T2 mapping. We analyzed the features in conventional MR imaging and also measured T2 values of the lesion vertebrae (LV) and unaffected adjacent vertebrae (UAV) in BS and TS patients, respectively.Results There were no significant differences in sex, age, national between BS and TS. It was significantly lower of the severe vertebral destruction, vertebral posterior convex deformity, dead bone, and abscess scope in BS when compared to TS (p < 0.001, p = 0.005, p = 0.048, p < 0.001, p < 0.001, respectively). The vertebral hyperplasia was significantly higher in BS when compared to TS (p < 0.001). The T2 value of the LV with BS was markedly higher than that in the UAV with BS and that in the LV and UAV with TS (p < 0.001, p < 0.037, p < 0.001, respectively). The T2 value of the LV with TS was significantly higher than that of the UAV in TS and BS (p < 0.001, p < 0.001, respectively). There were no significant differences in the T2 value of the UAV between BS and TS (P = 0.568). Conclusions The qualitative and quantitative evaluation may differentiate BS from TS. The conventional MR imaging helps to distinguish BS from TS by several distinctive features. MR T2 mapping has the additional potential to provide quantitative information between BS and TS.

Purpose Echinococcosis remains a major economic and severe public health problem in endemic areas. Bone echinococcosis is rare, and the vertebra and pelvis are the most common sites of echinococcosis involving the skeletal. Because of the clinical severe symptoms and high recurrence rate, it brings excellent trouble to patients. Methods This study retrospectively analyzed the clinical manifestations, laboratory tests, radiological findings, and treatment of 44 patients with vertebral and pelvic echinococcosis during a period of 16 years (2005–2020). Results The mean age was 43 years (25 males, 19 females; 19–68 years). The most common symptom was pain, followed by numbness, weakness, activity limitation, and progressive paraparesis. Enzyme-linked immunosorbent assay test (ELISA) results were positive in 18 cases (75%). There are 24 cases of hydatid infection of the spine, 14 hydatid infection of the pelvis, and six hydatid infection of both vertebra and pelvis. The site of infection was 13 (29.5%) thoracic, five (11.4%) lumbar, four (9.1%) lumbosacral, seven (15.9%) sacral, 19 (43.2%) ilium, seven (15.9%) hip, six (13.6%) ischium, five (11.4%) pubis, and two (4.5%) femur, respectively. The imaging findings were cystic dilatancy, septal, and irregular bone destruction. MRI has a special value in showing the relationship between the surrounding tissues and organs of cystic bone echinococcosis. All patients were followed up for at least one year. The mean follow-up time was 3.6 years. Conclusions Even in epidemic areas, the incidence of bone echinococcosis is relatively rare. However, when encountering the vertebral and pelvic destruction, consider bone echinococcosis’s possibility, especially for the herdsmen in endemic regions.