Diagnosis and classification in MRI of brucellar spondylitis

Shen, Lianfang; Jiang, Changqin; Jiang, Ruisheng; Fang, Wei; Feng, Qiang; Wang, Lishan; Wu, Chunyan; Ma, Zhuo

doi:10.1016/j.jrid.2017.08.005

Cited by 7 publications

(6 citation statements)

References 17 publications

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“…In our center, patients with this type of clinical situations are routinely followed as out-patients for at least 12 months. The diagnosis of infection was based on the observation of pus surrounding the implant during a new surgery and/or the identification of a microorganism from cultures of bone tissue or blood [20,21]. The bone biopsies could be provided by deep surgical samples or percutaneous biopsies.…”

Section: Gold Standardmentioning

confidence: 99%

Added value of [18F]fluorodeoxyglucose positron emission tomography/computed tomography for the diagnosis of post-operative instrumented spine infection

et al. 2019

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Post-operative instrumented spine infection (PISI) is an infrequent complication.Diagnosis of spinal implant infection can be difficult, especially in case of chronic infection.Methods: This retrospective study attempts to evaluate the diagnostic performance of [ 18 F]fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) in PISI. Imagings were performed between April 2010 and June 2018 among patients referred for suspected chronic spinal implant infection. PET/CT were performed more than 12 weeks after surgery. PET/CT images were re-interpreted independently by two nuclear medicine physicians without knowledge of the patient's conditions. PET/CT data were analyzed both visually and semi-quantitatively (SUV max ). MRI results were collected from medical records. The final diagnosis of infection was based on bacteriological cultures or a twelve-month follow-up.Results: Forty-nine PET/CT were performed in 44 patients (22 women, median age 65.0 years). Twenty-two patients had a diagnosis of infection during follow-up. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for PET/CT were 86.4%, 81.5%, 79.2%, and 88.0%. Sensitivity, specificity, PPV and NPV were 66.7%, 75.0%, 66.0%, 75.0% respectively for MRI and 50.0%, 92.6%, 84.6% and 69.4% for serum C-reactive protein (CRP). Although these values were higher for PET/CT than for MRI or CRP, the differences were not statistically significant. In this setting, false positives with PET/CT can be observed in case of previous spine infection or adjacent segments disc disease. False negatives can result of extensive instrumented arthrodesis or infection with low virulence bacteria. Conclusion:PET/CT is useful for the diagnosis of PISI. These results should be evaluated in further prospective study.

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Section: Gold Standardmentioning

confidence: 99%

Added value of [18F]fluorodeoxyglucose positron emission tomography/computed tomography for the diagnosis of post-operative instrumented spine infection

et al. 2019

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“…The T2 weighted image (T2WI) at 8 weeks postoperatively observed isosignal or slight hyperintense signal within the L5 and L6 vertebral bodies and hypersignal intense within the paravertebral soft tissue (Figure 3). According to the modified MRI classification system, all cases were further classified [17], in which the compound type was the most frequently type (70%) followed by the paraspinal abscess or psoas abscess type (20%) and discitis type (10%). None was classified as spondylitis or appendicitis type (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…In vivo plain radiography (Computed Radiography Digital Imaging System, Neu-Alpine, China), computed tomography (CT) (Brilliance 64-slice CT scanner, Siemens, Germany), and magnetic resonance imaging (MRI) (MAGNETOM Symphony 1.5 T MRI system, Siemens, Germany) analyses were performed to observe the targeted vertebral body and intervertebral disc at 4 and 8 weeks postoperatively under the general anesthesia. Specifically, the MRI findings were classified into five types, such as discitis type, spondylitis type, paraspinal/psoas abscess type, appendicitis type, and compound type, with a previously reported classification system (Table 1) [17].…”

Section: Methodsmentioning

confidence: 99%

Establishment and Initial Testing of a Medium-Sized, Surgically Feasible Animal Model for Brucellar Spondylodiscitis: A Preliminary Study

Cai

Xun

et al. 2019

BioMed Research International

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Brucellar spondylodiscitis, the most prevalent and significant osteoarticular presentation of human Brucellosis, is difficult to diagnose and usually yields irreversible neurologic deficits and spinal deformities. However, no animal models of Brucellar spondylodiscitis exist, allowing for preclinical investigations. The present study investigated whether intraosseous injection of attenuated Brucella melitensis vaccine into rabbits' lumbar vertebrae imitates the radiographic and histopathological characteristics of human Brucellar spondylodiscitis. Radiographic and histopathological analyses at 8 weeks postoperatively revealed radiographic changes within vertebral bodies and intervertebral discs, abscesses formation within the paravertebral soft tissue, and typical prominent inflammation response without caseous necrosis, which were largely comparable to human Brucellar spondylodiscitis. Such a medium-sized, surgically feasible rabbit model provides a promising in vivo setting for further preclinical investigation of Brucellar spondylodiscitis.

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“…Similar to actinomycosis, brucellosis is a bacterial granulomatous infection with worldwide distribution [ 62 , 89 , 90 ]. Brucellar spondylitis, most frequently located in the lumbar region, usually affects adults, particularly in their fifth decade of life [ 62 , 90 – 93 ]. In brucellar involvement of the spine, destructive and reparative processes occur concurrently, with eventual osteophyte-like reactive new bone formation on the anterior aspect of the affected vertebral bodies [ 62 , 92 ].…”

Section: Discussionmentioning

confidence: 99%

“…In brucellar involvement of the spine, destructive and reparative processes occur concurrently, with eventual osteophyte-like reactive new bone formation on the anterior aspect of the affected vertebral bodies [ 62 , 92 ]. Severe vertebral body destruction and collapse, as well as paravertebral abscess formation are uncommon features in brucellar spondylitis [ 62 , 89 , 92 , 93 ]. Therefore, it is unlikely that an infection with Brucella spp.…”

Section: Discussionmentioning

confidence: 99%

An unusual case of childhood osteoarticular tuberculosis from the Árpádian Age cemetery of Győrszentiván-Révhegyi tag (Győr-Moson-Sopron county, Hungary)

et al. 2021

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Ancient human remains exhibiting bony changes consistent with osteoarticular tuberculosis (OATB) indicate that the disease has afflicted mankind for millennia. Nonetheless, not many pediatric OATB cases have been published in the paleopathological literature–from Hungary, only three cases have been described up to now. In our paper, we demonstrate a child (S0603) from the Árpádian Age cemetery of Győrszentiván-Révhegyi tag (northwestern Hungary), who represents a unique case of OATB regarding both the pattern and severity of the observed bony changes. During the macromorphological and radiological investigations, the most serious alterations were discovered in the upper thoracic spine–the development of osteolytic lesions led to severe bone loss and consequent collapse and fusion of several adjacent vertebrae. The pathological process terminated in a sharp, rigid angular kyphosis. Disruption of the normal spine curvature resulted in consequent deformation of the whole thoracic wall–it became “rugby-ball-shaped”. The overall nature and pattern of the detected alterations, as well as their resemblance to those of described in previously published archaeological and modern cases from the pre-antibiotic era indicate that they are most consistent with OATB. Based on the severity and extent of the lesions, as well as on the evidence of secondary healing, S0603 suffered from TB for a long time prior to death. Besides body deformation, OATB resulted in consequent disability in daily activities, which would have required regular and significant care from others to survive. It implies that in the Árpádian Age community of Győrszentiván-Révhegyi tag, there was a willingness to care for people in need. Detailed archaeological case studies can give us a unique insight into the natural history and different presentations of OATB. Furthermore, they can provide paleopathologists with a stronger basis for diagnosing TB and consequently, with a more sensitive means of assessing TB frequency in past populations.

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Diagnosis and classification in MRI of brucellar spondylitis

Cited by 7 publications

References 17 publications

Added value of [18F]fluorodeoxyglucose positron emission tomography/computed tomography for the diagnosis of post-operative instrumented spine infection

Added value of [18F]fluorodeoxyglucose positron emission tomography/computed tomography for the diagnosis of post-operative instrumented spine infection

Establishment and Initial Testing of a Medium-Sized, Surgically Feasible Animal Model for Brucellar Spondylodiscitis: A Preliminary Study

An unusual case of childhood osteoarticular tuberculosis from the Árpádian Age cemetery of Győrszentiván-Révhegyi tag (Győr-Moson-Sopron county, Hungary)

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