Learning objectives
The choice of an optimum algorithm and technique of a radiology diagnostics of spondylodiscitis (SD) using CT and MRI.
Background
SD is an infectious disease of spine which involves the intervertebral disk (IVD),
vertebral bodies (VB),
joints,
paraspinal tissues.
Most common manifestations and complications of SD are VB destruction and fractures,
infiltration of IVD,
epidural and paraspinal (localized in muscles,
retroperitoneal space) puss collections,
spinal canal stenosis,
myelitis.
Except VB fractures and destruction,
almost all of these symptoms impossible to diagnose with routine X-ray because of its low sensitivity,
especially changes in spinal canal and spinal cord.
Valid diagnostics of SD by X-ray is possible...
Findings and procedure details
We used 128 slice CT (135 Kv,
400 mA,
slice thickness 1,0 mm and 0,5 mm after reconstruction) in pronation position,
view in bone and soft-tissue window.
In 23% we added in the diagnostics protocol CE (350 mg/ml of nonionic contrast agent,
80-100 ml) and repeat scan after 10,
20 and 120 sec,
especially in suspicious cases (epidural and soft tissue abscesses) directly after viewing of native images.
Accumulation of the CE in puss collections walls of soft tissue and epidural masses most pronounced and...
Conclusion
By our experience,
MRI most effective diagnostic method of diagnostic of SD and satisfies the basic diagnostic tasks.
The basic MRI protocol should include T2 (AX,
SG,
COR),
STIR and T1 (SG,
AX) through all interest zone by 3-4mm scans.
Interest zone should include all affected spine structures with contacting VB or IVD.
DWI doesn't give additional information.
Usage of CE can give some additional information,
but it isn’t affecting the decision on treatment plan.
CT can be useful as an indicative method for the...
References
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F.,
Popova N.A.,
Panyukhov A.G.
et al.
Spondylodiscitis: early diagnosis and treatment tactics.
Kazan’ medical journal,
2016,
97(6): 988-993.
2. Sobottke R.,
Seifert H.,
Fätkenheuer G.
et al.
Current diagnosis and treatment of spondylodiscitis.
Dtsch Arztebl Int,
2008,
105(10): 181–187.
3. Ramadani N.,
Dedushi K.,
Kabashi S.,
Mucaj S.
Radiologic diagnosis of spondylodiscitis,
role of magnetic resonance.
ACTA INFORM MED,
2017,
25 (1): 54–57.
4. Aiyer SN,
Shetty AP,
Kanna R.
et al.
Enterococcus faecalis causing delayed spondylodiscitis in a case with...