{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T11:22:22Z","timestamp":1777029742297,"version":"3.51.4"},"reference-count":56,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: This study aimed to determine if MRI features can distinguish between spinal infections caused by pyogenic bacteria and Mycobacterium tuberculosis. Methods: Patients underwent an MRI of the thoracolumbar spine with and without contrast. Three blinded observers assessed the images, using statistical tests for analysis. Results: Demographic characteristics and symptom duration were similar between patients with tuberculous and pyogenic spinal infections. In 36 cases of pyogenic infections, the MRI showed weakly delineated paravertebral tissue enhancement (76%), a hyperintense signal in the T2 TIRM sequences (89%), and homogeneous vertebral body enhancement (89%). In 32 cases of Mycobacterium infections, the MRI revealed well-delineated paravertebral changes, mixed vertebral body signals, and variable enhancement. Pyogenic infections were more often found in the lumbar spine (67%) and typically involved two vertebrae, while tuberculous infections preferred the thoracic spine (75%) and often involved two vertebrae, with 25% affecting three or more vertebrae. Conclusions: The MRI features can help differentiate between pyogenic and tuberculous spine infections, though none are definitive. The study suggests that MRI can be used for initial differentiation or as a diagnostic tool when biopsy or surgical exploration is not possible.<\/jats:p>","DOI":"10.3390\/jcm14020318","type":"journal-article","created":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T07:42:19Z","timestamp":1736235739000},"page":"318","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Never Ending Story\u2014What Are the Differentiable Magnetic Resonance Imaging Characteristics Between Pyogenic and Mycobacterial Thoracolumbar Infections?"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5475-1999","authenticated-orcid":false,"given":"Marcin","family":"Wa\u015bko","sequence":"first","affiliation":[{"name":"Department of Radiology and Imaging, The Medical Centre for Postgraduate Education, 01-813 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerzy","family":"Bia\u0142ecki","sequence":"additional","affiliation":[{"name":"Independent Public Clinical Hospital Named After Prof. Adam Gruca of the Center for Postgraduate Medical Education, 05-400 Otwock, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oleg","family":"Nowak","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, SPSK Im. A. Grucy, 05-400 Otwock, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnieszka","family":"Kwiatkowska-Miernik","sequence":"additional","affiliation":[{"name":"Department of Radiology, Radiotherapy and Nuclear Medicine, National Medical Institute of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agata","family":"Bujko-Ma\u0142kiewicz","sequence":"additional","affiliation":[{"name":"Department of Radiology, Radiotherapy and Nuclear Medicine, National Medical Institute of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerzy","family":"Walecki","sequence":"additional","affiliation":[{"name":"Department of Radiology, Radiotherapy and Nuclear Medicine, National Medical Institute of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.nic.2015.01.003","article-title":"Pyogenic spinal infections","volume":"25","author":"Tali","year":"2015","journal-title":"Neuroimaging Clin."},{"key":"ref_2","first-page":"1027","article-title":"Diagnosis and management of osteomyelitis","volume":"84","author":"Hatzenbuehler","year":"2011","journal-title":"Am. 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