MAGNETIC-RESONANCE-IMAGING OF TUBERCULOUS SPONDYLITIS

Study Design. This retrospective study analyzed the magnetic resonance imaging characteristics of tuberculous spondylitis. Objective. To des cribe the magnetic resonance imaging characteristics of tuberculous sp ondylitis and compare the diagnostic yield of magnetic resonance imagi ng versus other modalities. Summmary of Background Data. Tuberculous s pondylitis is not an uncommon occurrence with extrapulmonary disease. it requires prompt diagnosis and management. In the pre-magnetic reson ance imaging era, computed tomography was used to delineate the associ ated radiologic changes. Data are limited that describe the magnetic r esonance imaging pattern of tuberculous spondylitis and the effect of post-contrast :enhancement. Methods. The magnetic resonance imaging ch aracteristics of 28 vertebrae in 12 patients with tuberculous spondyli tis were studied. Results. The thoracic spine was the most commonly in volved region, with involvement occurring in the thoracic spine alone in 12 vertebrae (43%) and with other areas of the spine in an addition al five (18%). Partial involvement was detected in the majority of the vertebral lesions (24; 86%). Magnetic resonance imaging evidence of d isc space involvement was apparent in only 46% of the lesions. Paraspi nal abscess and epidural extension were documented by magnetic resonan ce imaging in 71% and 61% of lesions, respectively. Decreased signal i ntensity on T1-weighted images was demonstrated in 13 vertebrae (46%), with increased signal intensity on T2-weighted images seen only in fi ve (18%). Conclusion. Magnetic resonance imaging is a useful diagnosti c modality for patients with suspected tuberculous spondylitis. Partia l vertebral involvement and paraspinal and epidural extension were del ineated. Study of the signal intensity on T1- and T2-weighted images r evealed a pattern that may be dissimilar to that commonly reported. Po st-contrast enhancement adds more certainty to the diagnosis of tuberc ulous spondylitis.