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FIG 3. Case 3: 54-year-old woman with Aspergillus osteomyelitis. Biopsy was performed of the L2–L3 paraspinal inflammation and the L3 vertebra.
A, Sagittal T1-weighted (666/15/2) image of the lumbar spine shows multilevel disease with hypointensity in the L2, L3, vertebrae and superior endplate of L4 (arrows). Paraspinal and epidural disease is also present.
B and C, Sagittal and parasagittal contrast-enhanced T1-weighted (616/10/2) images show enhancing paraspinal and epidural inflammation. Disease also extends into the pedicles.
D and E, Sagittal T2-weighted (3500/102/2) fast spin-echo images with (D) and without (E) fat-saturation technique show hyperintense signal within the L2, L3, and L4 vertebrae and superior endplate of L4. Note the increased conspicuity of signal change with fat-saturation. In addition, the L3–L4 disk is normal in signal with a preserved intranuclear cleft. The L2–L3 disk is collapsed.
F, Axial T1-weighted (500/18/1.5) spin-echo image at the L3 level depicts epidural and paraspinal inflammation (arrows).
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