Infection versus neoplasm in the spine

This paper assesses the value of MR imaging for differentiating infection from neoplasm and for distinguishing the different forms of spine infection. Four radiologists performed blinded interpretation of spinal MR examinations of 149 patients with proved infection or neoplasm before and after applying proposed MR criteria for the infections (n = 89) included involvement of two or more consecutive vertebrae and disks. Specific criteria for tuberculosis included skip lesions, gibbus deformity, posterior element involvement, paraspinal abscesses and focal intraosseous abscesses demonstrated only with Gd-DTPA. Criteria for metastases (n = 42) included multiple vertebral involvement with moderate soft-tissue component, while primary neoplasms (n = 18) involved part or whole of a vertebra, with posterior elements being affected in both