J Korean Soc Radiol.  2015 Nov;73(5):300-306. 10.3348/jksr.2015.73.5.300.

Image-Guided Percutaneous Needle Biopsy for Infectious Spondylitis: Factors Affecting Culture Positivity

• Sung S
• Kwon JW

• KMID: 2079564
• DOI: http://doi.org/10.3348/jksr.2015.73.5.300

Abstract

PURPOSE
To evaluate the variable factors affecting the results of percutaneous needle biopsies for infectious spondylitis.
MATERIALS AND METHODS
In all, 249 patients who underwent both MRI and percutaneous needle biopsies due to a suspicion of infectious spondylitis were evaluated with respect to the following factors: the usage of antibiotics before the procedure, the location of the biopsy, the guiding equipment used, the experience level of the operators, and the number of biopsies performed.
RESULTS
The positivity of culture in cases of treated with antibiotics (16.3%) before the biopsy was lower than in the untreated cases (30.5%) (p = 0.004). Biopsies performed at the abscess (43.5%) and with fluoroscopic guidance (27.8%) showed higher culture positivity as well. The experience level of the operators and the number of biopsies had no effect on culture positivity.
CONCLUSION
The usage of antibiotics before the biopsy, the biopsy's location, and the guiding equipment used affect the culture positivity, while the experience levels of the operators and the number of biopsies do not have an effect.

MeSH Terms

Abscess
Anti-Bacterial Agents
Biopsy
Biopsy, Needle*
Fluoroscopy
Humans
Magnetic Resonance Imaging
Needles*
Spondylitis*
Anti-Bacterial Agents

Figure

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  Fig. 1 A 70-year-old man with back pain. A. A sagittal T2-weighted MR image shows the loss of fatty marrow signal intensity and subchondral bone destruction at the T11 and T12 vertebral bodies. A burst fracture of the T12 vertebral body is also noted. B. Contrast-enhanced T1-weighted image shows diffuse enhancement of the T11 and T12 vertebral bodies and phlegmon at the anterior epidural space of the T12 level. C. A percutaneous biopsy was performed at the T12 vertebral body under fluoroscopic guidance. The isolated organism was Staphylococcus aureus.

• 

  Fig. 2 A 68-year-old man with back pain. A. The T2-weighted axial image shows an intraosseous abscess in the L4 vertebral body with an anterior epidural extension (arrowheads). There is also a direct extension into the left psoas muscle (arrow). B. A percutaneous biopsy and aspiration were performed under CT guidance in the left psoas abscess. The isolated causative organism was Mycobacterium tuberculosis.

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