Diagnosis of osteomyelitis: utility of fat-suppressed contrast-enhanced MR imaging

• Published in: Radiology Vol. 189; no. 1; p. 251
• Main Authors: Morrison, W B, Schweitzer, M E, Bock, G W, Mitchell, D G, Hume, E L, Pathria, M N, Resnick, D
• Format: Journal Article
• Language: English
• Published: United States 01-10-1993
• Subjects: Adipose Tissue - pathology; Adolescent; Adult; Aged; Aged, 80 and over; Bone and Bones - injuries; Bone and Bones - surgery; Bone Marrow - pathology; Child; Contrast Media; Diagnosis, Differential; Gadolinium; Humans; Image Enhancement - methods; Magnetic Resonance Imaging - instrumentation; Magnetic Resonance Imaging - methods; Middle Aged; Osteomyelitis - diagnosis; Osteomyelitis - diagnostic imaging; Osteomyelitis - pathology; Prospective Studies; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Medronate
• ISSN: 0033-8419
• DOI: 10.1148/radiology.189.1.8204132

To assess the value of fat-suppressed contrast material-enhanced magnetic resonance (MR) imaging in the diagnosis of osteomyelitis.
T1- and T2-weighted MR imaging was performed in 51 cases of suspected osteomyelitis. Nonenhanced and contrast-enhanced T1-weighted fat-suppressed MR images were also obtained. Three-phase bone scan results were available for 30 cases. Complicating clinical factors, including chronic osteomyelitis (n = 26), postoperative state (n = 17), and neuropathic disease of the foot (n = 5), were identified in 73% of cases.
In the diagnosis of osteomyelitis, scintigraphy demonstrated a sensitivity of 61% and specificity of 33%. For nonenhanced MR imaging, sensitivity was 79% and specificity was 53%. For fat-suppressed contrast-enhanced imaging, sensitivity was 88% and specificity was 93%.
In diagnosing osteomyelitis in patients with complicating clinical factors, fat-suppressed contrast-enhanced MR imaging was significantly more sensitive than scintigraphy (P = .04) and significantly more specific than nonenhanced MR imaging (P = .02) or scintigraphy (P = .008).