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Thoracic Intradural Aspergillus Abscess Formation following Epidural Steroid Injection

Gaurav Saigala, M. Judith Donovan Posta and Dusko Kozica

a From the Department of Radiology, University of Miami School of Medicine, Miami, FL



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  		FIG 1. Sagittal MR images of the thoracolumbar spine obtained at the initial presentation.

A, T2-weighted image showing enlargement of the thoracolumbar cord with hyperintense intramedullary signal intensity (arrows).

B, Contrast-enhanced T1-weighted image showing enhancement of the leptomeninges and the cauda equina (arrows). The intradural abscess is also seen at the T10-T11 level (arrowhead).

C, Axial contrast-enhanced T1-weighted MR image depicting the intradural abscess dorsally at the T12-L1 level (long arrow). The conus (short arrow) is displaced anteriorly and compressed by the abscess.



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  		FIG 2. MR imaging performed 3 weeks after the initial presentation.

A, Sagittal contrast-enhanced T1-weighted image demonstrating intense enhancement and irregularity of the endplates at the L4-L5 level consistent with discitis/osteomyelitis (long arrow). A large ventral epidural collection was also noted (short arrow).

B, Axial contrast-enhanced fat-saturated T1-weighted image at the L3 level showing the ventral epidural abscess collection (arrow). Abnormal soft tissue enhancement of the psoas and the posterior paraspinal musculature was also noted.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X