MAGNETIC-RESONANCE-IMAGING OF SPINAL-CANAL ABSCESSES - 5 CASES AND A REVIEW OF THE LITERATURE

The spinal canal is an uncommon site for abscess formation resulting f rom bloodstream disseminated infection. Prognosis is often unfavorable . Rapid treatment is essential for satisfactory neurological recovery. Abscesses within the spinal canal are thus diagnostic and therapeutic emergencies. The neuroifectious and inflammatory manifestations and l aboratory findings vary considerably and are insufficient for diagnosi s. MRI plays a decisive role. The most commonly reported signs are the presence of an intramedullary collection givning a low-intensity sign al on T1-weighted images and a high-intensity signal on T2-weighted im ages with peripheral contrast uptake and generally extended adjacent m edullary edema. We report here five cases of spinal canal abscesses di agnoses with MRT at different stages of development (presupperative my elitis in two cases, constituted abscess in three cases). For each cas e we reviewed the;clinical course and describe the details of the imag ing findings. In our series, the collected abscesses presented as roun d lesions within the canal with contrast uptake. It is noteworthy that the periependymal gray platter adjacent to the lesion also took up th e contrast agent in all patients with a collected abscess. This sign h as not been described previously and appears to be a goog argument ori enting the diagnosis towards an infectious rather than tumoral formati on.