Meyers S P, Wiener S N
Department of Radiology, Mt Sinai Medical Center, Cleveland, Ohio 44106.
Arch Intern Med. 1991 Apr;151(4):683-7.
The clinical information and imaging data from 27 patients with hematogenous pyogenic vertebral osteomyelitis were reviewed. All patients had roentgenographic and magnetic resonance imaging examinations. Seventeen patients had computed tomograms; 17 had technetium Tc 99m medronate bone scans; and seven had gallium citrate Ga 67 scans. Magnetic resonance imaging, when used as a part of the initial radiologic evaluation, detected abnormalities consistent with osteomyelitis in all 27 patients. Magnetic resonance imaging also demonstrated paravertebral and/or epidural extension of infection in 14 patients, including seven patients who had neurologic signs of lower-extremity weakness. Roentgenograms, computed tomograms, technetium bone scans, and gallium scans had findings suggestive of the diagnosis in 48%, 65%, 71%, and 86% of the patients, respectively. We recommend magnetic resonance imaging as an important and perhaps critical imaging modality for detection of pyogenic vertebral osteomyelitis.
回顾了27例血源性化脓性脊椎骨髓炎患者的临床信息和影像资料。所有患者均接受了X线和磁共振成像检查。17例患者进行了计算机断层扫描；17例进行了锝Tc 99m亚甲基二膦酸盐骨扫描；7例进行了枸橼酸镓Ga 67扫描。磁共振成像作为初始放射学评估的一部分使用时，在所有27例患者中均检测到与骨髓炎一致的异常。磁共振成像还显示14例患者存在椎旁和/或硬膜外感染蔓延，其中7例患者有下肢无力的神经体征。X线、计算机断层扫描、骨扫描和镓扫描分别在48%、65%、71%和86%的患者中发现提示诊断的表现。我们推荐磁共振成像作为检测化脓性脊椎骨髓炎的一种重要且可能关键的成像方式。
