MR imaging of lumber epidural spinal infection

Five patients with spinal epidural abscess were evaluated with MR imaging. The lesions were best visualized on T1 weighted images with gadopentetate dimeglumine. In all five cases, peripheral enhancement surrounded a central focus of low signal intensity, representing necrotic abscess. In three cases, initial MR imaging showed normal appearance or only hyperintensity of the intervertebral disk. But a epidural abscess could be demonstrated clearly in each patient on follow-up MRI. Therefore, repetitive examinations may be warranted if there is suspicion of intraspinal infection on clinical grounds, even if the initial MRI scans show no abnormality.