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Author (up) Moritani, T.; Kim, J.; Capizzano, A.A.; Kirby, P.; Kademian, J.; Sato, Y. url  doi
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  Title Pyogenic and non-pyogenic spinal infections: emphasis on diffusion-weighted imaging for the detection of abscesses and pus collections Type Journal Article
  Year 2014 Publication The British Journal of Radiology Abbreviated Journal Br J Radiol  
  Volume 87 Issue 1041 Pages 20140011  
  Keywords Abscess; Aged; Decompression, Surgical; Diagnosis, Differential; *Diffusion Magnetic Resonance Imaging/methods; Discitis/*diagnosis; Epidural Abscess/*diagnosis/surgery; Female; Humans; Joint Diseases/diagnosis; Magnetic Resonance Imaging; Male; Middle Aged; Spinal Cord Diseases/*diagnosis; Suppuration/diagnosis; Zygapophyseal Joint  
  Abstract The incidence of spinal infections has increased in the past two decades, owing to the increasing number of elderly patients, immunocompromised conditions, spinal surgery and instrumentation, vascular access and intravenous drug use. Conventional MRI is the gold standard for diagnostic imaging; however, there are still a significant number of misdiagnosed cases. Diffusion-weighted imaging (DWI) with a b-value of 1000 and apparent diffusion coefficient (ADC) maps provide early and accurate detection of abscess and pus collection. Pyogenic infections are classified into four types of extension based on MRI and DWI findings: (1) epidural/paraspinal abscess with spondylodiscitis, (2) epidural/paraspinal abscess with facet joint infection, (3) epidural/paraspinal abscess without concomitant spondylodiscitis or facet joint infection and (4) intradural abscess (subdural abscess, purulent meningitis and spinal cord abscess). DWI easily detects abscesses and demonstrates the extension, multiplicity and remote disseminated infection. DWI is often a key image in the differential diagnosis. Important differential diagnoses include epidural, subdural or subarachnoid haemorrhage, cerebrospinal fluid leak, disc herniation, synovial cyst, granulation tissue, intra- or extradural tumour and post-surgical fluid collections. DWI and the ADC values are affected by susceptibility artefacts, incomplete fat suppression and volume-averaging artefacts. Recognition of artefacts is essential when interpreting DWI of spinal and paraspinal infections. DWI is not only useful for the diagnosis but also for the treatment planning of pyogenic and non-pyogenic spinal infections.  
  Address 1 Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0007-1285 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:24999081 Approved no  
  Call Number ref @ user @ Serial 79024  
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