Tehranzadeh J, Wang F, Mesgarzadeh M
Department of Radiology and Orthopedics, University of California, Irvine.
Crit Rev Diagn Imaging. 1992;33(6):495-534.
Early diagnosis and detection of osteomyelitis and differentiation of soft-tissue infection from bone involvement is a difficult clinical and imaging problem. Magnetic resonance imaging has proven to be as sensitive as bone scintigraphy in the early detection of osteomyelitis, and, with its superior spatial resolution, MR is often more specific than planar scintigraphy in differentiating bone from soft-tissue infection and separating arthritis, cellulitis, and soft-tissue abscess from osteomyelitis. In several comparative studies, MR has been more advantageous in detecting the presence and determining the extent of osteomyelitis over scintigraphy, CT scan, and conventional radiography. MRI may facilitate differentiation of acute from chronic osteomyelitis and may help to detect foci of active infection in the presence of chronic inflammation or posttraumatic lesions. MRI has a large role in evaluating the presence and extent of spondylitis and epidural abscess and certain distribution features may help recognize tuberculous spondylitis. Gadolinium-enhanced MR could be helpful in delineating the meninges and demonstrating the border and extent of epidural abscesses.
早期诊断和检测骨髓炎以及区分软组织感染与骨受累是一个困难的临床和影像学问题。磁共振成像已被证明在早期检测骨髓炎方面与骨闪烁显像一样敏感，并且凭借其卓越的空间分辨率，在区分骨与软组织感染以及将关节炎、蜂窝织炎和软组织脓肿与骨髓炎区分开来方面，磁共振成像通常比平面闪烁显像更具特异性。在多项比较研究中，与闪烁显像、CT扫描和传统放射照相相比，磁共振成像在检测骨髓炎的存在和确定其范围方面更具优势。磁共振成像有助于区分急性骨髓炎和慢性骨髓炎，并且在存在慢性炎症或创伤后病变时可能有助于检测活跃感染灶。磁共振成像在评估脊柱炎和硬膜外脓肿的存在和范围方面发挥着重要作用，某些分布特征可能有助于识别结核性脊柱炎。钆增强磁共振成像有助于描绘脑膜并显示硬膜外脓肿的边界和范围。
