Value of magnetic resonance imaging in brucellar spondylodiscitis.

Abstract

The aim of this retrospective study was to evaluate magnetic resonance (MR) imaging in patients with brucellar spondylodiscitis. Sixty-three patients with spondylodiscitis were diagnosed based on positive clinical findings, ≥1/160titres of brucella agglutination tests and/or positive blood cultures. MR imaging was performed in all of the patients with spondylodiscitis. Signal changes and enhancement of vertebral bodies, involvement of paravertebral soft tissues and epidural spaces, nerve root and cord compression and abscess formation were assessed. Of 63 patients with spinal brucellosis, eight had thoracic, 35 had lumbar, ten had cervical vertebral, seven had both thoracic and lumbar, and three had both lumbar and sacral vertebral involvement. Thirteen patients had cord compression and six had root compression. Four patients had facet-joint involvement, and one had erector spinae muscle involvement. Twenty-four had intervertebral disc narrowing. Seventeen patients were in the acute stage, 32 in the subacute stage and 14 in the chronic stage. Vertebral bodies, vertebral end plates and intervertebral disc spaces were hypointense and hyperintense in the acute stage, whereas they were hypointense and heterogeneous in the subacute and chronic stages on T1- and T2-weighted images, respectively. Brucella is still a public health problem in endemic areas. MR imaging is a highly sensitive and noninvasive imaging technique which should be first choice of imaging in the early diagnosis of spondylodiscitis.