GADOLINIUM-DTPA-ENHANCED MAGNETIC-RESONANCE-IMAGING OF MUSCULOSKELETAL INFECTIOUS PROCESSES

The purpose of this study was to assess whether gadolinium-enhanced ma gnetic resonance imaging (MRI) provides diagnostic information beyond that given by nonenhanced imaging in the evaluation of musculoskeletal infectious processes and whether it can be used for differentiating i nfectious from noninfectious inflammatory lesions. Magnetic resonance images performed with and without intravenous gadolinium-DTPA in 34 ca ses in which musculoskeletal infection had been clinically suspected w ere reviewed. Infectious lesions-including osteomyelitis, pyarthrosis, abscess, and cellulitis-were confirmed in a total of 22 cases: in 15 by biopsy or drainage and in 7 by clinical course. Our results show th at gadolinium-DTPA-enhanced MRI is a highly sensitive technique in dia gnosing musculoskeletal infectious lesions. It is especially useful in distinguishing abscesses from surrounding cellulitis/myositis. Lack o f contrast enhancement rules out infection with a high degree of certa inty. However, contrast enhancement cannot be used to reliably disting uish infectious from noninfectious inflammatory conditions.