Gadolinium-enhanced MR in spinal infection.
The purpose of this study was to determine what advantages the use of paramagnetic contrast material might have in evaluating patients clinically suspected of having spinal infection. To determine this we prospectively examined with noncontrast and contrast magnetic resonance (MR) 33 such patients and correlated the MR diagnoses with clinical and pathologic data. Our results showed the following advantages of gadolinium-enhanced MR: it (a) provided excellent anatomical delineation of all epidural abscesses, routinely differentiating them from the adjacent compressed thecal sac even when this was not possible by noncontrast MR; (b) increased observer confidence in the diagnosis of disk space infection and osteomyelitis in patients with equivocal noncontrast MR; (c) localized those portions of paraspinal masses most likely to yield a positive percutaneous biopsy; and (d) identified active infections from those that had responded adequately to antibiotic therapy. We conclude that contrast MR is a valuable adjunct to noncontrast MR when diagnosis, anatomical clarity, and/or lesion activity requires further elucidation.
Department of Radiology, University of Miami School of Medicine/Jackson Memorial Medical Center, FL 33101.
M J
MJ
Post
G
G
Sze
R M
RM
Quencer
F J
FJ
Eismont
B A
BA
Green
H
H
Gahbauer
D000038:Abscess / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001228:Aspergillosis / Q000175:diagnosis; D001424:Bacterial Infections / Q000175:diagnosis*; D003287:Contrast Media; D015299:Discitis / Q000175:diagnosis; D004824:Epidural Space; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008581:Meningitis / Q000175:diagnosis; D008875:Middle Aged; D009942:Organometallic Compounds; D010019:Osteomyelitis / Q000175:diagnosis; D004369:Pentetic Acid; D013122:Spinal Diseases / Q000175:diagnosis*; D013131:Spine / Q000473:pathology
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA