MR-IMAGING OF SPONDYLITIS WITH GADOPENTET ATE DIMEGLUMINE ENHANCEMENT

MR images of 17 patients with spondylitis were reviewed. T1 weighted s pin-echo scans were obtained in 17 patients and proton density and T2 weighted scans were obtained in 15 patients. Unenhanced and gadopentet ate dimeglumine enhanced scans were obtained in al patients, Five pati ents had pyogenic spondylitis, two patients tuberculous spondylitis, t wo patients fungal spondylitis and eight patients postoperative spondy litis. The four criteria described by Thrush and Enzmann were generall y applicable in our study : 1) narrowing of the intervertebral disc; 2 ) cortical bone erosion; 3) abnormal signal in the adjacent vertebral bodies and 4) abnormal paraspinous or epidural soft tissue. In additio n to plain sagittal T1 and T2 weighted images we suggest the routine a dministration of gadopentetate dimeglumine to assess the extent of the soft tissue mass and to differentiate postoperative spondylitis from a normal postoperative course, by showing disc enhancement. Disc enhan cement occurs infrequently in the normal postoperative course. If it i s associated with adjacent vertebral bone marrow changes it should be considered as postoperative spondylitis. A differential diagnosis betw een pyogenic, tuberculous, fungal and postoperative spondylitis was no t possible although the pattern of enhancement in tuberculous spondyli tis was different from the other cases of spondylitis.