[MR imaging of infectious spondylitis--usefulness of Gd-DTPA]

The aim of this study was to determine the usefulness of MR images obtained with gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) in cases of infectious spondylitis. In our study, four of seven patients were suffering from pyogenic spondylitis while the remaining three had tuberculous spondyitis. In comparison with noncontrast MR images, contrast MR images improved the delineation of disk space infection, extension of the lesions into paravertebral muscles, and the spinal canal, but demarcation of vertebral body lesions and extension of paravertebral fat tissue became less obvious. In the four patients who had pyogenic spondylitis, contrast MR images showed localized, intense vertebral body enhancement adjacent to the end plate and its communication with disk or paravertebral enhancement. In the three patients who had tuberculous spondylitis, contrast MR images showed geographic and/or ring-like enhancement of the vertebral body. We concluded that contrast MR images might be useful for better understanding the pathophysiology of infectious spondylitis and differentiating between tuberculous and pyogenic spondylitis.