Post M J, Sze G, Quencer R M, Eismont F J, Green B A, Gahbauer H
Department of Radiology, University of Miami School of Medicine/Jackson Memorial Medical Center, FL 33101.
J Comput Assist Tomogr. 1990 Sep-Oct;14(5):721-9. doi: 10.1097/00004728-199009000-00008.
The purpose of this study was to determine what advantages the use of paramagnetic contrast material might have in evaluating patients clinically suspected of having spinal infection. To determine this we prospectively examined with noncontrast and contrast magnetic resonance (MR) 33 such patients and correlated the MR diagnoses with clinical and pathologic data. Our results showed the following advantages of gadolinium-enhanced MR: it (a) provided excellent anatomical delineation of all epidural abscesses, routinely differentiating them from the adjacent compressed thecal sac even when this was not possible by noncontrast MR; (b) increased observer confidence in the diagnosis of disk space infection and osteomyelitis in patients with equivocal noncontrast MR; (c) localized those portions of paraspinal masses most likely to yield a positive percutaneous biopsy; and (d) identified active infections from those that had responded adequately to antibiotic therapy. We conclude that contrast MR is a valuable adjunct to noncontrast MR when diagnosis, anatomical clarity, and/or lesion activity requires further elucidation.
本研究的目的是确定使用顺磁性造影剂在评估临床怀疑患有脊柱感染的患者时可能具有哪些优势。为了确定这一点，我们对33例此类患者进行了非增强和增强磁共振（MR）前瞻性检查，并将MR诊断结果与临床和病理数据进行关联。我们的结果显示钆增强MR具有以下优势：它（a）能对所有硬膜外脓肿进行出色的解剖学描绘，即使在非增强MR无法做到时，也能常规地将它们与相邻受压的硬膜囊区分开来；（b）在非增强MR表现不明确的患者中，提高了观察者对椎间盘间隙感染和骨髓炎诊断的信心；（c）定位了椎旁肿块中最有可能获得阳性经皮活检结果的部分；（d）区分了对抗生素治疗反应良好的感染与仍处于活动期的感染。我们得出结论，当诊断、解剖清晰度和/或病变活动需要进一步阐明时，增强MR是对非增强MR的一种有价值的辅助手段。
