Postoperative lumbar epidural abscess: conventional and advanced magnetic resonance imaging findings

Abstract

A 54-year-old female patient was admitted to our department with numbness in both lower extremities during the past 2 weeks. She had a history of discectomy surgery. Spinal magnetic resonance (MR) imaging was performed. Magnetic resonance imaging revealed an extradural mass. The lesion was iso-hyperintense on T2-weighted images comparing muscle intensity (Fig. 1, Left and Right). Abscess or hematoma was considered for different diagnosis of mass. Gradient-recalled echo, diffusion- and contrast-enhanced MR imaging were performed. The mass was hyperintense on hemo sequence (Fig. 2). Thus, hematoma was excluded. On the diffusion-weighted imaging, the lesion was homogeneous increased signal intensity. The apparent diffusion coefficient map showed significant diffusion restriction (Fig. 3, Left and Right). The mass was also peripherally contrast enhanced (Fig. 4, Top, Bottom, and Right). With the MR imaging findings, the lesion was considered as an epidural abscess. Drainage treatment for abscess was planned.