Abstract
One case each of a spinal epidural and a subdural abscess is presented and utility of MRI as a diagnostic measure in these paraspinal suppurative diseases is discussed. MRI examination of a 21-year-old male with back pain, fever and quadriparesis revealed a linear lesion in the cervical epidural space. Lumbar tap yielded purulent fluid containing Staphylococcus aureus, thus diagnosed as spinal epidural abscess. Along with improvements with successful antibiotic therapy, the lesion was observed to disappear on MRI. Upon examination of an 82-year-old female with a fever and paraplegia, lumbar tap yielded pus with Escherichia coli and myelo-CT and MRI detected subdural masses in the low thoracic to the lumbar region, thus diagnosed as spinal subdural abscess. The rostral-caudal extension of the lesion was more precisely depicted by MRI. Concomitant spinal cord infarction at T-12 and L-1 escaped detection by MRI but was most relevant to the neurological signs. In this study MRI seemed to be a more suitable diagnostic tool than myelography or myelo-CT because MRI is non-invasive and repeatable, does not require potentially hazardous contrast medium and sagittal scanning of spinal cord is available which gives more precise information on the longitudinal extent of lesions.
