Kumar Yogesh, Gupta Nishant, Chhabra Avneesh, Fukuda Takeshi, Soni Neetu, Hayashi Daichi
Department of Radiology, Yale New Haven Health System at Bridgeport Hospital, 267 Grant Street, Bridgeport, 06610, CT, USA.
Department of Radiology, St. Vincent's Medical Center, 2800 Main Street, Bridgeport, 06606, CT, USA.
BMC Musculoskelet Disord. 2017 Jun 5;18(1):244. doi: 10.1186/s12891-017-1608-z.
Magnetic resonance (MR) imaging plays an important role in the evaluation of bacterial and tuberculous spondylodiscitis and associated complications. Owing to its high sensitivity and specificity, it is a powerful diagnostic tool in the early diagnosis of ongoing infections, and thus provides help in prompt initiation of appropriate, therapy which may be medical or surgical, by defining the extent of involvement and detection of complications such as epidural and paraspinal abscesses. More specifically, MR imaging helps in differentiating bacterial from tuberculous infections and enables follow up of progression or resolution after appropriate treatment. However, other non-infectious pathology can demonstrate similar MR imaging appearances and one should be aware of these potential mimickers when interpreting MR images. Radiologists and other clinicians need to be aware of these potential mimics, which include such pathologies as Modic type I degenerative changes, trauma, metastatic disease and amyloidosis. In this pictorial review, we will describe and illustrate imaging findings of bacterial and tuberculous spondylodiscitis, their complications and non-infectious pathologies that mimic these spinal infections.
磁共振(MR)成像在评估细菌性和结核性脊椎椎间盘炎及相关并发症中发挥着重要作用。由于其高敏感性和特异性,它是早期诊断正在进行的感染的有力诊断工具,通过确定受累范围和检测诸如硬膜外及椎旁脓肿等并发症,从而有助于及时启动适当的治疗,治疗方式可能是药物治疗或手术治疗。更具体地说,MR成像有助于区分细菌性感染和结核性感染,并能在适当治疗后对病情进展或缓解情况进行随访。然而,其他非感染性病变可能表现出类似的MR成像特征,在解读MR图像时应注意这些潜在的相似病变。放射科医生和其他临床医生需要了解这些潜在的相似病变,包括莫迪I型退变、创伤、转移性疾病和淀粉样变性等病变。在本图片综述中,我们将描述并展示细菌性和结核性脊椎椎间盘炎的影像学表现、其并发症以及模拟这些脊柱感染的非感染性病变。