Demonstration of evolution of hemispherical spondysclerosis by contrast enhanced Gd-DTPA magnetic resonance imaging
Background. The purpose of the study was to estimate the value of Gd-DTPA magnetic resonance imaging (MRI) in demonstrating the evolution of hemispherical spondylosclerosis (HSS).
Patients and methods. In eighteen patients with chronic low back pain and typical radiographic findings of HSS seen on plain films, Gd-DTPA MRI of the lumbar spine was performed. MRI morphological and signal intensity appearances of HSS were analysed and compared with radiographic changes.
Results. On the basis of MRI features, three distinct groups of cases were identifiable. Within the first group the region of dome-shaped osteosclerosis demonstrated low signal intensity on T1-weighted precontrast spin-echo images, high signal intensity on T2-weighted images and diffuse contrast enhancement on T1-weighted postcontrast images, findings compatible with bone marrow oedema and hyperaemia. The second group showed high signal intensity vertebral body corners surrounded by low signal intensity area, which indicated the combination of fat accumulation and the sclerotic bone. In the third intermediate group anterior disco-vertebral junctions revealed a mixture of MRI appearances characteristic of the first and the second group.
Conclusions. Gd-DTPA MRI is capable of demonstrating a spectrum of features which reflect the evolution of HSS. These typical appearances showed by MRI could be of eventual clinical relevance in following the progression of HSS.