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AJNR - American Journal of Neuroradiology

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MR Imaging Findings of Paravertebral Gossypiboma

H.S. Kim^a, T.-S. Chung^b, S.H. Suh^b and S.Y. Kim^a

^a Section of Neuroradiology, Department of Diagnostic Radiology, Ajou University, School of Medicine, Gyeonggi-do, Korea
^b Department of Diagnostic Radiology, Yonsei University Medical College, Yong Dong Severance Hospital, Seoul, Korea

View larger version (58K): [in this window] [in a new window]   Fig 1. A 59-year-old woman (patient 1) who underwent partial laminectomy 8 months before the MR imaging examination. The CT scan (A) shows a lobulating contoured isoattenuated paravertebral mass with a slightly hyperattenuated center. The axial T1-weighted image (B) shows the paravertebral mass with an intermediate signal intensity. The axial T2-weighted image (C) shows the paravertebral mass with a high signal intensity in the center and a low signal intensity at the periphery. Initial radiologic differential diagnosis was abscess. The pathologic specimen (D) of the mass shows a surgical gauze (arrow) at the center of the mass.

View larger version (83K): [in this window] [in a new window]   Fig 2. A 34-year-old man (patient 2) who underwent partial laminectomy and diskectomy 4 months before the MR imaging examination. Sagittal T2-weighted image (A) shows a paravertebral mass at the S1–2 level (arrow) with a high signal intensity in the center and a low signal intensity at the periphery. The axial T1-weighted image (B) with contrast enhancement shows bilateral posterior paravertebral masses with peripheral rim enhancement at the same location as in A. Initial radiologic differential diagnosis was abscess and gossypiboma. Small surgical gauzes were removed from the bilateral masses.

View larger version (93K): [in this window] [in a new window]   Fig 3. An 86-year-old man (patient 5) who underwent laminectomy and diskectomy 5 years before the MR imaging examination. Sagittal T1-weighted image (A) shows a posterior paravertebral mass with an intermediate signal intensity at the L2–3 level. Axial and sagittal T1-weighted images with contrast enhancement (B and C) show a right posterior paravertebral mass with peripheral rim enhancement. Initial radiologic differential diagnosis was abscess and gossypiboma. The mass was proved to contain a small surgical gauze surrounded by a thick fibrous capsule.

View larger version (76K): [in this window] [in a new window]   Fig 4. A 39-year-old man (patient 7) who underwent total laminectomy 7 years before the MR imaging examination. Sagittal T2-weighted image (A) shows a posterior paravertebral mass with low-signal-intensity and multifocal high-signal-intensity spots at the L4–5 level. Axial and sagittal T1-weighted images with contrast enhancement (B and C) show a mass with heterogeneous strong enhancement. Initial radiologic differential diagnosis was abscess, neurogenic tumor, and gossypiboma. Grossly, the mass did not contain a surgical gauze, but histopathologically, the cut surface of the mass contained suture threads surrounded by attenuated fibrosis related to the foreign body reaction.