Smids Carolijn, Kouijzer Ilse J E, Vos Fidel J, Sprong Tom, Hosman Allard J F, de Rooy Jacky W J, Aarntzen Erik H J G, de Geus-Oei Lioe-Fee, Oyen Wim J G, Bleeker-Rovers Chantal P
Department of Internal Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
Sint Maartenskliniek, P.O. Box 9011, 6500 GM, Nijmegen, The Netherlands.
Infection. 2017 Feb;45(1):41-49. doi: 10.1007/s15010-016-0914-y. Epub 2016 Jun 17.
The purpose of this study was to evaluate the diagnostic value of F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT scan) and magnetic resonance imaging (MRI) in diagnosing spondylodiscitis and its complications, such as epidural and paraspinal abscesses.
From January 2006 to August 2013 patients with a clinical suspicion of spondylodiscitis, with an infection, or with fever of unknown origin were retrospectively included if F-FDG-PET/CT and MRI of the spine were performed within a 2-week time span. Imaging results were compared to the final clinical diagnosis and follow-up data were collected.
Sixty-eight patients were included of whom 49 patients were diagnosed with spondylodiscitis. MRI showed an overall sensitivity of 67 % and specificity of 84 %. Diagnostic accuracy was 58 %, when MRI was performed within 2 weeks after the start of symptoms and improved to 82 %, when performed more than 2 weeks after onset of symptoms. F-FDG-PET/CT showed a sensitivity of 96 % and a specificity of 95 %, with no relation to the interval between the scan and the start of symptoms.
As compared to MRI, F-FDG-PET/CT has superior diagnostic value for detecting early spondylodiscitis. After 2 weeks both techniques perform similarly.
本研究旨在评估氟脱氧葡萄糖（FDG）正电子发射断层扫描及计算机断层扫描（PET/CT扫描）和磁共振成像（MRI）在诊断脊椎椎间盘炎及其并发症（如硬膜外和椎旁脓肿）方面的诊断价值。
回顾性纳入2006年1月至2013年8月临床怀疑患有脊椎椎间盘炎、感染或不明原因发热且在2周内进行了脊柱F-FDG-PET/CT和MRI检查的患者。将影像学结果与最终临床诊断进行比较，并收集随访数据。
纳入68例患者，其中49例被诊断为脊椎椎间盘炎。MRI的总体敏感性为67%，特异性为84%。症状出现后2周内进行MRI检查时诊断准确性为58%，症状出现2周后进行检查时诊断准确性提高到82%。F-FDG-PET/CT的敏感性为96%，特异性为95%，与扫描和症状开始之间的间隔无关。
与MRI相比，F-FDG-PET/CT在检测早期脊椎椎间盘炎方面具有更高的诊断价值。2周后两种技术表现相似。
