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.