Radiologic Diagnosis of Spondylodiscitis, Role of Magnetic Resonance

Ramadani, Naser; Dedushi, Kreshnike; Kabashi, Serbeze; Muçaj, Sefedin

doi:10.5455/aim.2017.25.54-57

Cited by 13 publications

(11 citation statements)

References 21 publications

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“…In the DWI sequence, epidural and paravertebral abscesses are characterized by reduced diff usion. Fat suppression technique improves diff erentiation between bone, soft tissue components and contiguous structures [7,[24][25][26][27][28].…”

Section: Methodsmentioning

confidence: 99%

Early Imaging and Course-of-Disease Control Markers of Pyogenic Vertebral Osteomyelitis

Bohdan¹,

Plakhtyr²,

Bohdan³

2021

PSSS MS

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Background. The diagnosis of early pyogenic vertebral osteomyelitis is essential for prompt determination of treatment strategy and prevention of suppurative-destructive complications, although the nonspecifi c clinical manifestation obstructs timely disease detection. Aim. To analyse the clinical accuracy of various radiological imaging methods for early detection and control over vertebral osteomyelitis course Materials and methods. A retrospective study of standardized clinical data of patients (N = 54) who underwent treatment at the Neurosurgery Department of the MМCC WR between 2010 and 2020 was carried out. Patients were observed for 12–36 months. Study fi ndings and discussion. Our study revealed that during radiological imaging, infl ammatory changes in the vertebrae specifi c to osteomyelitis were not found in any case, which signifi cantly delays the diagnosis. The study analysed and grouped radiological signs of the infl ammatory process spread in the vertebrae in case of spondylodiscitis by CT and MR stages. Spondylodiscitis was diagnosed by CT of the spine in the late third stage only in 29.0 % of patients. Nonspecifi c destructive changes of vertebrae were detected in 51.6% of persons, which required additional MRI examination to establish the diagnosis. In 19.4% of those examined in the presence of the fi rst MR stage, no specifi c CT signs of osteomyelitis were found. MRI scan of the spine is the main specifi c (93 %), accurate (94 %) and sensitive (97 %) method for early detection of pyogenic osteomyelitis. Although according to the world literature, MRI is not sensitive enough to assess the dynamics of the infl ammatory process in the spine, the progressive increase in signal intensity of vertebral cortex on T1-weighted images within aff ected vertebrae correlates well with infl ammation resolving and C-reactive protein (CRP) level normalization. We described this radiological sign as a «vertebral rim» phenomenon (VRP). In our study, a reliable correlation was found between CRP level and the «vertebral rim» phenomenon on MRI. Conclusions. For early detection of pyogenic vertebral osteomyelitis, MRI examination is the main specifi c and sensitive method. We suggest combining the CRP level and «vertebral rim» sign in practice as dynamics of spondylodiscitis markers and justifi cation of antibacterial therapy strategy.

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Section: Methodsmentioning

confidence: 99%

Early Imaging and Course-of-Disease Control Markers of Pyogenic Vertebral Osteomyelitis

Bohdan¹,

Plakhtyr²,

Bohdan³

2021

PSSS MS

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“…The presence of a paraspinal mass, observed as a retropharyngeal space increase (cervical SD), parietal pleura rejection (thoracic SD) and psoas effacement (lumbar SD) may be visible [10]. In the chronic phase (more than 3 months) extensive bone destruction can be observed with alterations of sagittal and / or coronal alignment (scoliosis, kyphosis), reactive sclerosis, ankylosis and spondylolisthesis [10][11][12].…”

Section: Imagingmentioning

confidence: 99%

“…In subacute phases however, an epidural abscess that exerts a mass effect towards the epidural region can be detected, with hyperintense images at the center of the lesion on T2 weighted sequences and hypo to isointense T1 weighted images. T1 hypointense and T2 hyperintense images with homogeneous lesion reinforcement can be seen upon contrast administration [12].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

“…Chronic changes observed in MRI images are decreased vertebral intensity on T1 and T2 images, sclerosis, minimal reinforcement upon contrast administration and deformities (kyphosis, scoliosis, ankylosis, spondylolisthesis) [11,12]. MRI can be useful in outpatient follow-up, however its use is not recommended in at least a period of up 2 months after beginning treatment [10].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

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Pyogenic Cervical Spondylodiskitis: Case Report and Current Literature Review

Martínez¹

2018

MOJOR

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Background: Cervical pyogenic spondylodiskitis accounts for less than 11% of all infectious spondylodiskitis. Its main origin is hematogenous, its most common etiological agent is Staphylococcus aureus, and however, different microorganisms can be found to cause this infection. Its insidious course, aggressiveness, mortality and high risk of sequela make timely diagnosis and early treatment a fundamental part of the patient's prognosis.Case presentation: 47 year old woman, with type II diabetes mellitus and arterial hypertension with quadriparesis of three months evolution. A diagnosis of pyogenic spondylodiskitis C4-C5 ASIA C due to Staphylococcus aureus was made, cervical debridement, decompression and fusion were performed and intravenous vancomycin and meropenem were administered for nine days.Results: She had a satisfactory outcome in the postoperative period, leaving the hospital with oral levofloxacin for three months, presenting recovery of general neurological status and gait recovery (ASIA E). Conclusion:There are several reports on elevated probability of neurological disease and its sequela, as well as on its high mortality rate (21%); however, there are few studies with an adequate level of evidence regarding the diagnosis and treatment of cervical ED.The current guidelines suggest the early empiric broad spectrum antibiotic administration within the first contact in aggressive cases, and posterior surgical treatment in addition to specific antibiotic therapy.

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“…ние в позвонках локализуется в его вентральных и латеральных отделах (91%) [2]. Единственный позвонок без вовлечения МПД поражается реже, что заставляет подозревать туберкулезную природу возбудителя [4]. Li и соавт.…”

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Spondylodiscitis Diagnostics in Nowadays: Basic Ct and Mri Signs

Винокуров

Belenkaya

Yudin

et al. 2019

Lučevaâ diagn. ter.

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For many reasons spondylodiscitis (SDC) is a complicated pathology. It is caused by difficulty in early diagnostics, the need for surgical treatment (including repeated interventions), long term and high cost of antibiotic therapy. Objective. The goal is to identify and describe the main CT and MRI symptoms of SDC, to assess their frequency and specificity. The next aim is to note the peculiarities of the radiologist’s practice with such patients. Materials and methods. We studied the data of 25 patients with proved SDC, and we analyzed CT and MRI symptoms (both common and rare), and the role of contrast enhancement (СE) in both methods and important clinical and laboratory aspects. Results.The infiltration of vertebral bodies and intervertebral discs were the most frequent SDC signs, abscesses also were very common. The most significant type of abscess was epidural which led to the formation of vertebral canal stenosis and to neurological deficit. The important methodological aspects of the MRI study were noted to improve its quality. Conclusion. We recommend performing both CT and MRI, if possible, for all patients with SDC because of the different diagnostic tasks that are important for clinicians.CE significantly increases the MRI informativity.

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Radiologic Diagnosis of Spondylodiscitis, Role of Magnetic Resonance

Cited by 13 publications

References 21 publications

Early Imaging and Course-of-Disease Control Markers of Pyogenic Vertebral Osteomyelitis

Early Imaging and Course-of-Disease Control Markers of Pyogenic Vertebral Osteomyelitis

Pyogenic Cervical Spondylodiskitis: Case Report and Current Literature Review

Spondylodiscitis Diagnostics in Nowadays: Basic Ct and Mri Signs

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