FDG Positron Emission Tomography for Differentiation of Degenerative and Infectious Endplate Abnormalities in the Lumbar Spine Detected on MR Imaging
Katrin D. M. Stumpe1,
Marco Zanetti2,
Dominik Weishaupt3,
Juerg Hodler2,
Norbert Boos4 and
Gustav K. von Schulthess1
1 Department of Medical Radiology, Nuclear Medicine, University Hospital,
Ramistr. 100, CH-8091 Zurich, Switzerland.
2 Department of Radiology, Orthopedic University Hospital Balgrist, Forchstr.
340, CH-8008 Zurich, Switzerland.
3 Department of Diagnostic Radiology, University Hospital, Zurich,
Switzerland.
4 Department of Orthopedic Surgery, Orthopedic University Hospital Balgrist,
Zurich, Switzerland.
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Fig. 1A. —60-year-old man with false-positive findings on MR imaging
for L4-L5 disk-space infection. Unenhanced sagittal T1-weighted fast spin-echo
MR image (TR/TE, 700/12) shows bone marrow abnormalities of low signal
intensity at L4-L5 intervertebral level (arrowheads).
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Fig. 1B. —60-year-old man with false-positive findings on MR imaging
for L4-L5 disk-space infection. Sagittal T2-weighted fast spin-echo MR image
(5000/112) shows marked hyperintensity in disk (arrows).
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Fig. 1C. —60-year-old man with false-positive findings on MR imaging
for L4-L5 disk-space infection. Coronal T1-weighted fat-suppressed MR image
shows slight peripheral disk enhancement (arrows) and periosteal
enhancement (arrowheads).
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Fig. 1D. —60-year-old man with false-positive findings on MR imaging
for L4-L5 disk-space infection. Sagittal position emission tomography scan is
negative for disk-space infection at site of abnormality (arrow)
detected on MR imaging.
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Fig. 2A. —56-year-old woman with false-negative findings on MR imaging
for L5-S1 disk-space infection. Unenhanced sagittal T1-weighted fast spin-echo
MR image (TR/TE, 700/12) shows bone marrow abnormalities of high signal
intensity adjacent to both end-plates at L5-S1 disk intervertebral level. In
adjacent T1-weighted section (not shown), endplate abnormalities were also
seen with low signal intensity.
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Fig. 2B. —56-year-old woman with false-negative findings on MR imaging
for L5-S1 disk-space infection. Corresponding sagittal T2-weighted fast
spin-echo MR image (5000/112) shows increased signal at both endplates at
L5-S1 disk intervertebral level. In addition, centrally located increased
signal intensity is seen in disk at level L5-S1 (arrow).
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Fig. 2C. —56-year-old woman with false-negative findings on MR imaging
for L5-S1 disk-space infection. Sagittal T1-weighted fat-suppressed MR image
(560/11) shows contrast enhancement around intervertebral disk at L5-S1 level
(arrowheads) and adjacent bone marrow.
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Fig. 2D. —56-year-old woman with false-negative findings on MR imaging
for L5-S1 disk-space infection. Sagittal position emission tomography scan
shows focus of increased FDG uptake in inferior aspect of L5 vertebral body
(arrow).
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Fig. 3A. —66-year-old man with back pain and proven L2-L3 disk-space
infection. Unenhanced sagittal T1-weighted fast spin-echo MR image (TR/TE,
700/12) shows typical signs of disk-space infection at L2-L3 intervertebral
level with hypointense, not well-demarcated, bone marrow abnormalities.
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Fig. 3B. —66-year-old man with back pain and proven L2-L3 disk-space
infection. Corresponding sagittal T2-weighted fast spin-echo MR image
(5000/112) shows hyperintense bone marrow (arrowheads) and disk
abnormalities.
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Fig. 3C. —66-year-old man with back pain and proven L2-L3 disk-space
infection. Sagittal contrast-enhanced fat-suppressed T1-weighted MR image
(800/20) shows infection marked by disk enhancement and altered disk shape as
well as enhanced bone marrow abnormalities at L2-L3 intervertebral level.
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Fig. 3D. —66-year-old man with back pain and proven L2-L3 disk-space
infection. Sagittal positron emission tomography scan shows increased FDG
uptake in two adjacent vertebral bodies (arrow) at L2-L3
intervertebral disk level.
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Copyright © 2002 by the American Roentgen Ray Society.
