Kowalski T J, Layton K F, Berbari E F, Steckelberg J M, Huddleston P M, Wald J T, Osmon D R
Division of Infectious Diseases, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
AJNR Am J Neuroradiol. 2007 Apr;28(4):693-9.
Follow-up MR imaging examinations are increasingly used to monitor response to treatment in patients with spine infection. We aim to describe follow-up MR imaging examination findings 4-8 weeks after diagnosis and initiation of treatment of spine infections and to compare with clinical findings.
Thirty-three patients with spinal infection and available baseline and 4-8-week follow-up MRIs were included in this retrospective cohort study. Baseline and follow-up MR imaging were graded by 2 neuroradiologists blinded to clinical characteristics and outcome. Clinical findings and outcomes were independently obtained by retrospective review of the medical record.
Compared with baseline MR imaging examinations, follow-up MR imaging more frequently demonstrated vertebral body loss of height (26/33 [79%] versus 14/33 [47%]; P < .001) and less frequently demonstrated epidural enhancement (19/32 [59%] versus 29/33 [88%]; P = .008), epidural canal abscess (3/32 [9%] versus 15/33 [45%]; P = .001), and epidural canal compromise (10/32 [31%] versus 19/33 [58%]; P = .008). Most follow-up MR imaging examinations demonstrated less paraspinal inflammation and less epidural enhancement compared with baseline. However, vertebral body enhancement, disk space enhancement, and bone marrow edema more often were equivocal or appeared worse compared with baseline. Twenty-one of 32 (66%) follow-up MR imaging examination overall grades were considered improved, 5 (16%) were equivocal, and 6 (19%) were worse. No single MR imaging finding was associated with clinical status.
Soft tissue findings, not bony findings, should be the focus of clinicians interpreting follow-up MR imaging results. No single MR imaging parameter was associated with the patients' clinical status.
后续磁共振成像检查越来越多地用于监测脊柱感染患者的治疗反应。我们旨在描述脊柱感染诊断和开始治疗后4 - 8周的后续磁共振成像检查结果，并与临床结果进行比较。
本回顾性队列研究纳入了33例有脊柱感染且有可用基线及4 - 8周随访磁共振成像的患者。由2名对临床特征和结果不知情的神经放射科医生对基线和随访磁共振成像进行分级。通过回顾病历独立获取临床结果。
与基线磁共振成像检查相比，随访磁共振成像更常显示椎体高度丢失（26/33 [79%] 对比14/33 [47%]；P <.001），而硬膜外强化较少见（19/32 [59%] 对比29/33 [88%]；P =.008），硬膜外脓肿（3/32 [9%] 对比15/33 [45%]；P =.001），以及硬膜外腔受压（10/32 [31%] 对比19/33 [58%]；P =.008）。与基线相比，大多数随访磁共振成像显示椎旁炎症和硬膜外强化较少。然而，椎体强化、椎间盘间隙强化和骨髓水肿与基线相比更常不明确或看起来更严重。32例随访磁共振成像检查的总体分级中，21例（66%）被认为有所改善，5例（16%）不明确，6例（19%）更差。没有单一的磁共振成像表现与临床状态相关。
临床医生解读随访磁共振成像结果时，软组织表现而非骨质表现应作为重点。没有单一的磁共振成像参数与患者的临床状态相关。
