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Journal of Korean Neurosurgical Society 2006;40(5): 351-356.
Serial Changes of MR Images Throughout the Stages of Infection of Spondylodiscitis.
Tae Hyung Kwon, Zun Zae Shin, Sung Uk Kuh, Young Sul Yoon, Yong Eun Cho, Young Soo Kim
1Department of Neurosurgery, Yonsei University College of Medicine, Yongdong Severance Hospital, Seoul, Korea. kuhsu@yumc.yonsei.ac.kr
2Department of Neurosurgery, Kwanghye Spine Center, Seoul, Korea.
Spondylodiscitis has been diagnosed by clinical, radiological and laboratory methods. MR imaging is well known as an excellent diagnostic tool for spondylodiscitis. However, the changes in MR images throughout the treatment process has not been studied. Thus we have analyzed the serial changes of MR images throughout the stages of infection.
Ten patients were selected for retrospective reviewed who had been treated at our institute for infectious spondylodiscitis between 2000 and 2005. These patients had been followed-up at least six months and had taken more than a couple of series of MR scans. We classified the MR images into four groups according to the stages of treatment for the infection and compared them to the clinical and laboratory findings.
MR image signals changed minimally or appeared to be normal in the early stages. The progression of spondylodiscitis was characterized by a low T1 WI signal and a high T2 WI signal in disc and vertebral body. The signal changes of the MR images were then propagated and the endplate was destructed. During the treatment, the destructed endplate became stabilized and the signal intensity of both T1 and T2 WI were fixed to low-or iso-intensity.
We can determine the serial signal changes based on MR images according to the treatment of spondylodiscitis. We can therefore determine the status of the infection and the stage of treatment, as well as the diagnosis of spondylodiscitis using serial MR images.
Key Words: Spondylodiscitis; MR image; Infection; C-reactive protein
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