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Fig 4. Spinal MR imaging.
A, Coronal T2-weighted (TR/TE, 2500/120) thoracolumbar image shows widespread paravertebral soft tissue (arrowheads) and enlarged right psoas muscle (star) displacing the right kidney. The abscess has almost completely replaced the psoas muscle, though a small portion of it can still be noticed between the abscess and vertebral colon. High-signal-intensity patchy areas on vertebral bodies are consistent with osteomyelitis.
B, T2-weighted and (C) contrast-enhanced T1-weighted (TR/TE, 580/14) sagittal scans. Enhancing prevertebral soft-tissue lesions (arrowheads) and osteomyelitis with high signal intensity on the T2-weighted scan, with patchy contrast enhancement on the T1-weighted scan, are seen. Subcutaneous flank mass reveals high T2 and low T1 signal intensity with rim enhancement (curved arrow). Midthoracic disk space narrowing suggesting diskitis and adjacent endplate bony destruction are also evident.
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