MRI Spine Area of Interest Because of its excellent tissue characterization and anatomic delineation, MRI without and with IV contrast has a sensitivity of 96% and a specificity of 94% for the evaluation of patients with suspected spine infection [3,7,14,16,24,37,51]. MRI also provides optimal depiction of the intraspinal contents including the epidural space and the spinal cord [6,17,18]. The use of MRI without and with IV contrast on an emergent or urgent basis, in patients with preexisting risk factors for possible spine infection and with an elevated ESR, may facilitate a more prompt diagnosis of spinal canal compromise by epidural abscess or other infected displaced structures. Epidural abscess is a feared complication of spine infection that may result in spinal cord and or cauda equina compression. The use of IV contrast helps to identify these abnormal epidural fluid collections, define their size and extent, and determine the presence of spinal cord and/or cauda equina compression [3]. MRI when performed without IV contrast may have utility, because it can show findings that are suggestive of possible spine infection, including marrow or paraspinal muscle edema, abnormal fluid collections, areas of abnormal signal, abnormality within the intervertebral disc, and adjacent vertebral endplates and gross structural abnormalities of the involved spine segment(s) [3,10,14,16,17,30,63-66,69]. MRI performed with IV contrast only is not considered to be useful because the precontrast MRI study is required for comparison in order to confirm areas of suspected abnormality within the spine segment(s) of interest. The presence and extent or the absence of contrast enhancement are important imaging features in suspected spinal infection and are best evaluated by comparing the pre- and postcontrast MRI examinations.
Suspected Spine Infection PCAs. MRI Spine Area of Interest Because of its excellent tissue characterization and anatomic delineation, MRI without and with IV contrast has a sensitivity of 96% and a specificity of 94% for the evaluation of patients with suspected spine infection [3,7,14,16,24,37,51]. MRI also provides optimal depiction of the intraspinal contents including the epidural space and the spinal cord [6,17,18]. The use of MRI without and with IV contrast on an emergent or urgent basis, in patients with preexisting risk factors for possible spine infection and with an elevated ESR, may facilitate a more prompt diagnosis of spinal canal compromise by epidural abscess or other infected displaced structures. Epidural abscess is a feared complication of spine infection that may result in spinal cord and or cauda equina compression. The use of IV contrast helps to identify these abnormal epidural fluid collections, define their size and extent, and determine the presence of spinal cord and/or cauda equina compression [3]. MRI when performed without IV contrast may have utility, because it can show findings that are suggestive of possible spine infection, including marrow or paraspinal muscle edema, abnormal fluid collections, areas of abnormal signal, abnormality within the intervertebral disc, and adjacent vertebral endplates and gross structural abnormalities of the involved spine segment(s) [3,10,14,16,17,30,63-66,69]. MRI performed with IV contrast only is not considered to be useful because the precontrast MRI study is required for comparison in order to confirm areas of suspected abnormality within the spine segment(s) of interest. The presence and extent or the absence of contrast enhancement are important imaging features in suspected spinal infection and are best evaluated by comparing the pre- and postcontrast MRI examinations.