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Magnetic Resonance Imaging Factors Associated With Positive Result Using Broad-Range Polymerase Chain Reaction And Culture In Image-Guided Biopsy Or Aspiration For Infectious Spondylitis 2014

Category Interventional Se Un Yun Sang Hoon Lee Min Hee Lee Hye won Chung Myung Jun Shin Purpose The purpose of our study was to evaluate the magnetic resonance imaging (MRI) factors of broad-range polymerase chain reaction (PCR) methods and culture in image-guided percutaneous biopsy or aspiration for the patients of infectious spondylitis. Materials & Methods The study was performed to 43 consecutive patients with suspected of infectious spondylitis undergoing computed tomography (CT)- or ultrasonography (US)-guided biopsy or aspiration. Microbiological results were obtained using both culture and PCR. All patients had MRI before the procedure. MRI and medical records were reviewed to determine whether the following factors affected the microbiological result: target of biopsy or aspiration (vertebral body, soft tissue abscess, disc, and soft tissue inflammation), presence of soft tissue abscess, severity of paravertebral soft tissue inflammation, involvement of multiple vertebral bodies, subligamentous spread of inflammation, and disc involvement. Statistical analysis was performed using Fisher’s exact test and binary logistic regression test. Results Of the 43 patients, 26 (60.5%) patients were revealed microorganism in PCR or culture. Broad-range PCR was positive in 22 (51.2%), whereas the culture was positive in 12 (27.9%), positive of PCR only was 14 (32.6%), and culture was 4 (9.3%). Six was positive at PCR and 2 at culture in bone biopsy, 15 was positive at PCR and 8 at culture in abscess aspiration. Target was the significant factor that associated with positive and negative results (P=0.013). Furthermore, targeting to abscess showed significant impact on the rate of positive result (P ASSR image file.docx ASSR image file.docx Conclusion Not only culture, PCR was essential for the diagnosis of infectious spondylitis. And aspiration of abscess is recommended for the diagnosis of infectious spondylitis. References 1. Diagnostic yield of fluoroscopy-guided biopsy for infecitous spondylitis. Am J Neuroradiol 2013;34:233-38 2. Imaging-guided bone biopsy for osteomyelitis: Are there factors associated with positive or negative cultures? Am J Radiol 2007;188:1529-1534 3. CT-guided fine-needle aspiration in vertebral osteomyelitis : true usefulness of a common practice. Clin Rheumatol 2009;28:315-320 4. Usefulness of a direct 16S rRNA gene PCR assay of percutaneous biopsies or aspirates for etiological diagnosis of vertebral osteomyelitis. Diagn Microbiol Infect Dis. 2013 Oct 14 5. Ribosomal RNA Operon Copy Number Database. Nucleic Acids Res 2001;29:181-4