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The Diagnostic Performance of Multi-Detector Computed Tomography (MDCT) in Depiction of Acute Spondylodiscitis in an Emergency Department

1
Department of Neuroradiology, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy
2
Department of Advanced Biomedical Sciences, Federico II University Naples, 80131 Naples, Italy
3
Department of Internal Medicine, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy
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Department of Radiology, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy
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Department of Anesthesia and Intensive Care, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy
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Department of Neuoradiology, AORN A. Cardarelli, Via Antonio Cardarelli, 80131 Naples, Italy
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Department of Neurorsurgery, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy
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Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via de Crecchio, 80138 Naples, Italy
*
Author to whom correspondence should be addressed.
Tomography 2022, 8(4), 1895-1904; https://doi.org/10.3390/tomography8040160
Received: 13 May 2022 / Revised: 12 July 2022 / Accepted: 24 July 2022 / Published: 26 July 2022
(This article belongs to the Section Neuroimaging)
Background: The diagnosis of acute spondylodiscitis can be very difficult because clinical onset symptoms are highly variable. The reference examination is MRI, but very often the first diagnostic investigation performed is CT, given its high availability in the acute setting. CT allows rapid evaluation of other alternative diagnoses (e.g., fractures), but scarce literature is available to evaluate the accuracy of CT, and in particular of multi-detector computed tomography (MDCT), in the diagnosis of suspected spondylodiscitis. The aim of our study was to establish MDCT accuracy and how this diagnostic method could help doctors in the depiction of acute spondylodiscitis in an emergency situation by comparing the diagnostic performance of MDCT with MRI, which is the gold standard. Methods: We searched our radiological archive for all MRI examinations of patients who had been studied for a suspicion of acute spondylodiscitis in the period between January 2017 and January 2021 (n = 162). We included only patients who had undergone MDCT examination prior to MRI examination (n = 25). The overall diagnostic value of MDCT was estimated, using MRI as the gold standard. In particular, the aim of our study was to clarify the effectiveness of CT in radiological cases that require immediate intervention (stage of complications). Therefore, the radiologist, faced with a negative CT finding, can suggest an elective (not urgent) MRI with relative serenity and without therapeutic delays. Results: MDCT allowed identification of the presence of acute spondylodiscitis in 13 of 25 patients. Specificity and positive predictive value were 100% for MDCT, while sensitivity and negative predictive value were 68% and 50%, respectively, achieving an overall accuracy of 76%. In addition, MDCT allowed the identification of paravertebral abscesses (92%), fairly pathognomonic lesions of spondylodiscitis pathology. Conclusions: The MDCT allows identification of the presence of acute spondylodiscitis in the Emergency Department (ED) with a satisfactory accuracy. In the case of a positive CT examination, this allows therapy to be started immediately and reduces complications. However, we suggest performing an elective MRI examination in negative cases in which pathological findings are hard to diagnose with CT alone. View Full-Text
Keywords: spondylodiscitis; multi-detector computer tomography (MDCT); magnetic resonance imaging (MRI) spondylodiscitis; multi-detector computer tomography (MDCT); magnetic resonance imaging (MRI)
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MDPI and ACS Style

Negro, A.; Somma, F.; Tortora, M.; Lugarà, M.; Tamburrini, S.; Coppola, M.G.; Piscitelli, V.; Fasano, F.; Sicignano, C.; Vargas, O.; Pace, G.; Giardiello, M.; Iannuzzi, M.; Toro, G.; De Simone, F.; Catalano, M.; Carbone, R.; Rocco, C.; Saturnino, P.P.; Della Gatta, L.; Villa, A.; Tortora, F.; Gemini, L.; Caranci, F.; D’Agostino, V. The Diagnostic Performance of Multi-Detector Computed Tomography (MDCT) in Depiction of Acute Spondylodiscitis in an Emergency Department. Tomography 2022, 8, 1895-1904. https://doi.org/10.3390/tomography8040160

AMA Style

Negro A, Somma F, Tortora M, Lugarà M, Tamburrini S, Coppola MG, Piscitelli V, Fasano F, Sicignano C, Vargas O, Pace G, Giardiello M, Iannuzzi M, Toro G, De Simone F, Catalano M, Carbone R, Rocco C, Saturnino PP, Della Gatta L, Villa A, Tortora F, Gemini L, Caranci F, D’Agostino V. The Diagnostic Performance of Multi-Detector Computed Tomography (MDCT) in Depiction of Acute Spondylodiscitis in an Emergency Department. Tomography. 2022; 8(4):1895-1904. https://doi.org/10.3390/tomography8040160

Chicago/Turabian Style

Negro, Alberto, Francesco Somma, Mario Tortora, Marina Lugarà, Stefania Tamburrini, Maria Gabriella Coppola, Valeria Piscitelli, Fabrizio Fasano, Carmine Sicignano, Ottavia Vargas, Gianvito Pace, Mariarosaria Giardiello, Michele Iannuzzi, Gabriella Toro, Fiore De Simone, Marco Catalano, Roberto Carbone, Concetta Rocco, Pietro Paolo Saturnino, Luigi Della Gatta, Alessandro Villa, Fabio Tortora, Laura Gemini, Ferdinando Caranci, and Vincenzo D’Agostino. 2022. "The Diagnostic Performance of Multi-Detector Computed Tomography (MDCT) in Depiction of Acute Spondylodiscitis in an Emergency Department" Tomography 8, no. 4: 1895-1904. https://doi.org/10.3390/tomography8040160

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