Shaoyin Duan, Presenter: Nothing to Disclose

Gina Diprimio, Abstract Co-Author: Nothing to Disclose

Mark E. Schweitzer MD, Abstract Co-Author: Nothing to Disclose

Conclusion: Patients with the culture negative disc space infection have  obvious marrow edema and endplate erosion, more frequency of disc fluid and long complaint days and less frequency of facet fliuid. Follow up MR at more than 1 month can find these lesions with significant absorption or shrinkage, while within 1 month follow-up maybe not.

Objective: As many disc space infections are culture negative, as there is increasing evidence that a subgroup of end plate reactive changes actually represent indolent infections, we sought to compare the MR findings of disc space infections with and without positive cultures  

Methods: the clinical and MR imaging of 26 patients with disc space infections, of which 9 cases (15 discs) who were blood and local tissue culture negative, and 17 cases (21 disc) who were culture positive, were retrospectively evaluated by two radiologists. All patients had the histological confirmation, the negative group have the follow up MR, performed within 1 month in 5 cases, 1-3 months in 7 and more than 3 months in 5 and responded appropriately to antibiotic treatment; the positive group were histological diagnosis as the acute inflammation. MR findings , epidemiology were compared. Statistical analysis consisted of T and chi squarred tests

Results: Nine patients of the negative group had the complaint times of 2 days to 4 months, lesions in single disc in 6 cases and 2-4 discs in 3. MR showed the marrow edema, endplate erosions, disc fluid, paraspinal mass and lesions CE with 100.0% sensitivity, The negative group were compared with the positive,The former is more obvious in the extent of the marrow edema and endplate erosion, and more frequency of disc fluid and longer days of complaint, while the latter is more frequency of facet fluid (P＜0.05). follow-up MR of negative group showed the obvious absorption or shrinkage of marrow edema, disc fluid, paraspinal mass, epidural collection, facet fluid and the decreased lesions CE among within 1 month, 1-3 months and more than 3 months (P＜0.05), but without the significant difference between the first examination and the within 1 month follow up ( P＞0.05).

Duan, S, Diprimio, G, Schweitzer, M, Does the MR of Culture Negative Disc Space Infection Differ from Culture Positive Infections?.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13028618.html