An Imaging-Based Approach to Spinal Cord Infection.
Infections of the spinal cord, nerve roots, and surrounding meninges are uncommon, but highly significant given their potential for severe morbidity and even mortality. Prompt diagnosis can be lifesaving, as many spinal infections are treatable. Advances in imaging technology have now firmly established magnetic resonance imaging (MRI) as the gold standard for spinal cord imaging evaluation, enabling the depiction of infectious myelopathies with exquisite detail and contrast. In this article, we aim to provide an overview of MRI findings for spinal cord infections with special focus on imaging patterns of infection that are primarily confined to the spinal cord, spinal meninges, and spinal nerve roots. In this context, we describe and organize this review around 5 distinct patterns of transverse spinal abnormality that may be detected with MRI as follows: (1) extramedullary, (2) centromedullary, (3) eccentric, (4) frontal horn, and (5) irregular. We seek to classify the most common presentations for a wide variety of infectious agents within this image-based framework while realizing that significant overlap and variation exists, including some infections that remain occult with conventional imaging techniques.
Department of Radiology, San Francisco General Hospital, San Francisco, CA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA. Electronic address: Jason.talbott@ucsf.edu.
Jason F
JF
Talbott
Department of Radiology, San Francisco General Hospital, San Francisco, CA.
Jared
J
Narvid
Department of Radiology, Weill Cornell Medical School, New York, NY.
J Levi
JL
Chazen
Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA; Department of Radiology, San Francisco General Hospital, San Francisco, CA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA; Department of Radiology, Weill Cornell Medical School, New York, NY.
Cynthia T
CT
Chin
Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA; Department of Radiology, San Francisco General Hospital, San Francisco, CA.
Vinil
V
Shah
D002494:Central Nervous System Infections / Q000000981:diagnostic imaging* / Q000382:microbiology*; D003287:Contrast Media; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D059906:Neuroimaging / Q000379:methods*; D013118:Spinal Cord Diseases / Q000000981:diagnostic imaging* / Q000382:microbiology*
D003287:Contrast Media