Findings of Dagirmanjian et al for Vertebral Osteomyelitis Seen on MRI

Anatomic Location	T1-weighted	T2-weighted
vertebral body	hypointense	hyperintense (variable)
endplate	loss of definition	NA
intervertebral disc	hypointense	hyperintense

 

T2-weighted image with hypointense vertebral body can occur if there is sclerosis of the marrow space, which is a late finding.

 

Contrast enhancements of disk and adjacent vertebral body:

(1) patchy to linear enhancement in the disk

(2) thick or thin and continuous or discontinuous enhancement at the disk periphery

 

Contrast enhancement of paraspinal and epidural soft tissues:

(1) ring : indicates paraspinal and epidural infection

(2) homogeneous: indicates phlegmon

(3) heterogenous: indicates abscess or phlegmon