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Related Experiment Videos

Spinal epidural abscess: evaluation with gadolinium-enhanced MR imaging

Y Numaguchi1, D Rigamonti, M I Rothman

  • 1Department of Radiology, University of Maryland Medical System, Baltimore 21201.

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|May 1, 1993
PubMed
Summary

Magnetic resonance (MR) imaging aids in diagnosing spinal epidural abscess (SEA). Follow-up MR imaging correlates with patient outcomes, but persistent enhancement requires careful interpretation alongside clinical data.

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Area of Science:

  • Radiology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Spinal epidural abscess (SEA) is a serious condition requiring prompt diagnosis and management.
  • Magnetic resonance (MR) imaging is a key modality for evaluating SEA.
  • Understanding MR imaging features is crucial for accurate diagnosis and prognosis.

Purpose of the Study:

  • To evaluate the role of MR imaging with gadopentetate dimeglumine in diagnosing and monitoring spinal epidural abscess (SEA).
  • To identify common MR imaging findings associated with SEA and correlate them with clinical outcomes.

Main Methods:

  • Retrospective review of MR imaging studies in 25 patients with confirmed spinal epidural abscess (SEA).
  • Gadopentetate dimeglumine contrast was administered.

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  • Follow-up MR imaging was performed in 17 patients.
  • Correlation of imaging findings with clinical data and laboratory results.

    • Main Results:

    • Diskitis was the primary infectious focus in 20 patients; 5 had diffuse SEA without diskitis.
    • Common MR appearances included enhancement of the SEA's solid portion and enhancement around pus collections.
    • Dural enhancement was frequent with extensive vertebral involvement.
    • Follow-up abscess size changes correlated with clinical status.
    • Persistent enhancement at infection or surgical sites was common despite clinical improvement.

    Conclusions:

    • MR imaging is valuable for diagnosing spinal epidural abscess (SEA) and assessing treatment response.
    • Specific MR imaging patterns can suggest the presence and extent of SEA.
    • Persistent enhancement on follow-up MR imaging does not always indicate active infection and requires clinical correlation for accurate prognosis.