The Correlation between Follow-up MRI Findings and Laboratory Results in Pyogenic Spondylodiscitis
Background: Although MRI is the gold-standard imaging method in the diagnosis of spondylodiscitis, role of follow-up imaging is debated and there can be discrepancies with regard to the significance of bony or soft tissue responses to treatment. Purpose of our study is to test whether the MRI changes on follow-up imaging correlate with laboratory findings of treatment response.
Methods: A total of 48 patients with pyogenic spondylodiscitis who underwent baseline and follow-up MRI were retrospectively reviewed. The extent of bone marrow edema, paravertebral soft tissue inflammation, and disc height were compared on baseline and follow-up MRIs with the C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels obtained from the medical records at baseline and on follow-up. Relationships between the MRI and laboratory changes were analyzed using the Spearmann correlation test.
Results: The mean MRI follow-up period was 42.25 days. Based on the CRP (resolved: n=19, resolving: n=19, and aggravated: n=10), there was significant correlation between the laboratory results and the changes in the bone and soft tissues (p < 0.01, both). The correlation was best with soft tissue changes (rho: 0.48) followed by bony changes (rho: 0.41). Based on the ESR (resolved: n=8, resolving: n=22, and worsened: n=18), the correlation was stronger with bone changes (rho: 0.45, p < 0.01) than it was with soft tissue changes (rho: 0.39, p = 0.01).
Conclusion: Follow-up MRI findings of pyogenic spondylodiscitis show variable tissue responses. CRP was best correlated with soft tissue changes, while ESR showed the best association with bony changes.
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Posted 20 Jun, 2020
On 02 Jul, 2020
On 19 Jun, 2020
On 19 Jun, 2020
On 18 Jun, 2020
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On 15 Jun, 2020
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On 06 May, 2020
On 02 May, 2020
Received 02 May, 2020
Received 01 May, 2020
On 30 Apr, 2020
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On 16 Apr, 2020
On 15 Apr, 2020
On 15 Apr, 2020
Received 20 Mar, 2020
On 20 Mar, 2020
Received 19 Mar, 2020
On 18 Mar, 2020
On 10 Mar, 2020
On 09 Mar, 2020
Invitations sent on 09 Mar, 2020
On 03 Mar, 2020
On 02 Mar, 2020
The Correlation between Follow-up MRI Findings and Laboratory Results in Pyogenic Spondylodiscitis
Posted 20 Jun, 2020
On 02 Jul, 2020
On 19 Jun, 2020
On 19 Jun, 2020
On 18 Jun, 2020
On 07 Feb, 2020
On 15 Jun, 2020
On 19 May, 2020
On 18 May, 2020
On 07 Feb, 2020
On 06 May, 2020
On 02 May, 2020
Received 02 May, 2020
Received 01 May, 2020
On 30 Apr, 2020
Invitations sent on 29 Apr, 2020
On 16 Apr, 2020
On 15 Apr, 2020
On 15 Apr, 2020
Received 20 Mar, 2020
On 20 Mar, 2020
Received 19 Mar, 2020
On 18 Mar, 2020
On 10 Mar, 2020
On 09 Mar, 2020
Invitations sent on 09 Mar, 2020
On 03 Mar, 2020
On 02 Mar, 2020
Background: Although MRI is the gold-standard imaging method in the diagnosis of spondylodiscitis, role of follow-up imaging is debated and there can be discrepancies with regard to the significance of bony or soft tissue responses to treatment. Purpose of our study is to test whether the MRI changes on follow-up imaging correlate with laboratory findings of treatment response.
Methods: A total of 48 patients with pyogenic spondylodiscitis who underwent baseline and follow-up MRI were retrospectively reviewed. The extent of bone marrow edema, paravertebral soft tissue inflammation, and disc height were compared on baseline and follow-up MRIs with the C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels obtained from the medical records at baseline and on follow-up. Relationships between the MRI and laboratory changes were analyzed using the Spearmann correlation test.
Results: The mean MRI follow-up period was 42.25 days. Based on the CRP (resolved: n=19, resolving: n=19, and aggravated: n=10), there was significant correlation between the laboratory results and the changes in the bone and soft tissues (p < 0.01, both). The correlation was best with soft tissue changes (rho: 0.48) followed by bony changes (rho: 0.41). Based on the ESR (resolved: n=8, resolving: n=22, and worsened: n=18), the correlation was stronger with bone changes (rho: 0.45, p < 0.01) than it was with soft tissue changes (rho: 0.39, p = 0.01).
Conclusion: Follow-up MRI findings of pyogenic spondylodiscitis show variable tissue responses. CRP was best correlated with soft tissue changes, while ESR showed the best association with bony changes.
Figure 1
Figure 2
Figure 3
Figure 4