Diagnosis of osteomyelitis: utility of fat-suppressed contrast-enhanced MR imaging.
OBJECTIVE
To assess the value of fat-suppressed contrast material-enhanced magnetic resonance (MR) imaging in the diagnosis of osteomyelitis.


METHODS
T1- and T2-weighted MR imaging was performed in 51 cases of suspected osteomyelitis. Nonenhanced and contrast-enhanced T1-weighted fat-suppressed MR images were also obtained. Three-phase bone scan results were available for 30 cases. Complicating clinical factors, including chronic osteomyelitis (n = 26), postoperative state (n = 17), and neuropathic disease of the foot (n = 5), were identified in 73% of cases.


RESULTS
In the diagnosis of osteomyelitis, scintigraphy demonstrated a sensitivity of 61% and specificity of 33%. For nonenhanced MR imaging, sensitivity was 79% and specificity was 53%. For fat-suppressed contrast-enhanced imaging, sensitivity was 88% and specificity was 93%.


CONCLUSIONS
In diagnosing osteomyelitis in patients with complicating clinical factors, fat-suppressed contrast-enhanced MR imaging was significantly more sensitive than scintigraphy (P = .04) and significantly more specific than nonenhanced MR imaging (P = .02) or scintigraphy (P = .008).
Morrison
W B
WB
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107.
Schweitzer
M E
ME
Bock
G W
GW
Mitchell
D G
DG
Hume
E L
EL
Pathria
M N
MN
Resnick
D
D
D000273:Adipose Tissue / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000473:pathology; D001842:Bone and Bones / Q000293:injuries / Q000601:surgery; D002648:Child; D003287:Contrast Media; D003937:Diagnosis, Differential; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013669:Technetium Tc 99m Medronate
D003287:Contrast Media; D005682:Gadolinium; D013669:Technetium Tc 99m Medronate