Lumbar epidural brucellar abscess causing nerve root compression

Objectives: To evaluate the usefulness of MR sequences for the differential diagnosis of spinal brucellar abscesses which mimic lumbar disc herniation . Methods: We analyzed six patients with brucellar abscesses. who had symptom s mimicking lumbar disc herniation. The study group consisted of three wome n. and three men who were 15 - 67 (mean = 37) years old. Patients were imag ed in the axial and sagittal planes with a I.0-T MR scanner using a spine c oil. Results: The level of abscesses were accurate in 100% (six of six)of patien ts with MR imaging. MRI examinations revealed an extradural soft tissue mas s which were iso- to hypointense compared to spinal cord on T1WI and hyperi ntense on T2-weighted images. By contrast study, diffuse homogeneous or sli ghtly heterogeneous enhancements were seen. Conclusion: Lumbar extradural brucellar abscess can have lumbar disc diseas e symptoms. MRI may non-invasively and rapidly reveal the presence of spina l abscess and degree of extension to the spinal canal. Extradural brucellar abscess should be included in the differential diagnosis of radicular symp toms caused by disc herniation.