Imaging of Spondylodiscitis

Raghavan, Meera; Lazzeri, Elena; Palestro, Christopher J.

doi:10.1053/j.semnuclmed.2017.11.001

Cited by 77 publications

(85 citation statements)

References 65 publications

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“…Vertebral endplate destruction is typical for spondylodiscitis [21][22][23][24][25][27][28][29][30]. However, in this study, endplates in MT1, and early and advanced spondylodiscitis were found to be normal in up to 10.2%, 18.2%, and 5.7%, respectively.…”

Section: Discussioncontrasting

confidence: 70%

Vertebral Bone Marrow and Endplate Assessment on MR Imaging for the Differentiation of Modic Type 1 Endplate Changes and Infectious Spondylodiscitis

Schwarz‐Nemec

Friedrich

Stihsen

et al. 2020

JCM

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On magnetic resonance (MR) imaging, Modic type 1 (MT1) endplate changes and infectious spondylodiscitis share similar findings. Therefore, this study investigated vertebral bone marrow and endplate changes to enable their differentiation. The lumbar spine MR examinations of 91 adult patients were retrospectively included: 39 with MT1; 19 with early spondylodiscitis without abscess; and 33 with advanced spondylodiscitis with abscess. The assessment included percentage of bone marrow edema on sagittal short tau inversion recovery images, and the signal ratio of edema to unaffected bone and endplate contour (normal; irregular, yet intact; blurred; destructive) on sagittal unenhanced T1-weighted images. Differences were tested for statistical significance by Chi-square test and mixed model analysis of variance. The MR diagnostic accuracy in differentiating MT1 and spondylodiscitis was assessed by cross-tabulation and receiver-operating characteristic analysis. The endplate contours, edema extents, and T1-signal ratios of MT1 (extent, 31.96%; ratio, 0.83) were significantly different (p < 0.001) from early spondylodiscitis (56.42%; 0.60), and advanced spondylodiscitis (91.84%; 0.61). The highest diagnostic accuracy (sensitivity, 94.87%; specificity, 94.23%; accuracy, 94.51%) in identifying MT1 was provided by an irregular, yet intact endplate contour. This may be a useful MR feature for the differentiation between MT1 and spondylodiscitis, particularly in its early stage.

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Section: Discussioncontrasting

confidence: 70%

Vertebral Bone Marrow and Endplate Assessment on MR Imaging for the Differentiation of Modic Type 1 Endplate Changes and Infectious Spondylodiscitis

Schwarz‐Nemec

Friedrich

Stihsen

et al. 2020

JCM

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“…This is supported by several studies that have shown 18 F-FDG PET/CT to be at least equivalent to MRI in diagnosing spondylodiscitis and may be used as a means of monitoring the response to treatment [ 33 – 37 ]. In the absence of PET/CT facilities, other nuclear medicine modalities including 99m Tc-MDP bone scan and Gallium scan (particularly when combined with single photon emission computed tomography (SPECT)/CT) have also been shown to be viable alternatives for the detection of spondylodiscitis [ 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Spondylodiscitis following endovascular abdominal aortic aneurysm repair: imaging perspectives from a single centre’s experience

et al. 2018

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ObjectiveVery few reports have previously described spondylodiscitis as a potential complication of endovascular aortic aneurysm repair (EVAR). We present to our knowledge the first case series of spondylodiscitis following EVAR based on our institution’s experience over an 11-year period. Particular attention is paid to the key imaging features and challenges encountered when performing spinal imaging in this complex patient group.Materials and MethodsOf 1,847 patients who underwent EVAR at our institution between January 2006 and January 2017, a total of 9 patients were identified with imaging features of spondylodiscitis (0.5%). All cross-sectional studies before and after EVAR were assessed by a Consultant Musculoskeletal Radiologist and a Musculoskeletal Radiology Fellow to evaluate for features of spondylodiscitis.ResultsAll 9 patients had single-level spondylodiscitis involving lumbosacral levels adjacent to the aortic/iliac stent graft. Eight out of nine patients had an extensive anterior paravertebral phlegmon/abscess that was contiguous with the infected stent graft and native aneurysm sac ± anterior vertebral body erosion. Epidural disease was present in only 3 out of 9 patients and was a minor feature. MRI was non-diagnostic in 3 out of 9 patients owing to susceptibility artefact. 18F-FDG PET/CT accurately depicted the spinal level involved and adjacent paravertebral disease in patients with non-diagnostic MRI and was adopted as the follow-up modality in 3 out of 5 surviving patients.ConclusionSpondylodiscitis is a rare complication post-EVAR. Imaging features of disproportionate anterior paravertebral disease and anterior vertebral body bony involvement suggest direct spread of infection posteriorly to the adjacent vertebral column. Use of MRI versus 18F-FDG PET/CT as the optimal imaging modality should be directed by the type of stent graft deployed.

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“…As to coarctation of the aorta, this results in dilatation of the ascending aorta, which is unlikely to cause compressive erosion of the vertebral bodies. Also it leads to "notching of the ribs" as the result of the collateral circulation, a condition which was not obeserved in the CT scan images (Figure 3c) [3] A chronic abscess would result in a "ragged" appearance of the anterior walls of the vertebral bodies, whereas in this case the margins are smooth [4] (Figure 3d Although there is evidence of structures within the cavity these are unrecognizable as specific anatomical entities, therefore a retrospective diagnosis concerning the type of cystic lesion and its composition is impossible. Due to the absence of an association with the neural tube, any cause within the spinal canal (such as purely neural tumors -e.g.…”

Section: Discussionmentioning

confidence: 99%

Erosive effects of a posterior mediastinal mass in a 18th to early 19th c. Spanish child mummy

Loynes

Charlier²,

Perciaccante

et al. 2018

Forensic Sci Med Pathol

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During the 2011 restoration works in the central nave of the church of the Assumption of Our Lady, known as "The Piquete", in the village of Quinto (about 50 kms southwest of Zaragoza, Spain), the remains of 70 individuals were uncovered. Of these there were 32 mummified bodies, four of which have been investigated with CT scans. Here we report on the findings in one such individual, namely a child of between 7 and 8 years of age, whose sex is debatable but may well be female. The main pathological finding is the presence of pressure erosion and distortion of the upper thoracic spine, the cause of which is discussed with the conclusion that this may well represent a neurenteric duplication cyst. The possible consequences of such a lesion are considered.

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Imaging of Spondylodiscitis

Cited by 77 publications

References 65 publications

Vertebral Bone Marrow and Endplate Assessment on MR Imaging for the Differentiation of Modic Type 1 Endplate Changes and Infectious Spondylodiscitis

Vertebral Bone Marrow and Endplate Assessment on MR Imaging for the Differentiation of Modic Type 1 Endplate Changes and Infectious Spondylodiscitis

Spondylodiscitis following endovascular abdominal aortic aneurysm repair: imaging perspectives from a single centre’s experience

Erosive effects of a posterior mediastinal mass in a 18th to early 19th c. Spanish child mummy

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