Magnetic resonance imaging for the diagnosis of tuberculous spondylitis

Objectives, The purposes Ot this study were to evaluate the nature of the paraspinal soft tissue mess and the location of the lesion involved using magnetic resonance imaging and to correlate tJiese observations with surgical Findings, Summary of Background Data. In the past, lobcrculous spondylitis was diagnosed by plain radiography and since the 1970's, computed lo inuyrap by has beer useful method fo r assessing tubarculous spondylitis. In contrast to most imaging methods, MRI has the advantages of improved contrast resolution for bone and soft tissues and versatility of direct imaging in multiple planes. Method;, Medical records and magnetic resonance imaging studies o f 22 patients wrth bacteriologies I ly and/or histologically proved tuberculous spondylitis were reviewed. In each patient, tha numbers of vertebrae involved wore evaluated as well as which columns of vertebrae were affected and the signal intensities of lesions. In addition, an attempt was made to determine if granulation tissue differed from the abscoss baaed on magnetic resonance imaging appearance and to compare the outcome w ith surgical findlags. Results. The average number of vertebras Involved per patient was 2, 8 and T8 and T9 were the vertebree most frequently affected. The destruction of vertebrae and discs was easily identified in both sagittal and axial planes. The peripheral margins were exclusively enhanced in all cases. Of particular interest, the posterior aspect of tho vertebral body was predominantly involved. Mostly the involvement of both anterior and middle columns was noted. With the sld of intravenous administration of megnstrc resonance contrast agents, magnetic resonance imaging was highly accurate in distinguishing the granulation tissue from the cold abscess, Conclusions. Magnetic resonance Imaging demonstrated excellent imagos ol bone destruction and soft tissue mass, and provided mformat/on in multiple planes, thereby delineating the extant of involvement In tuberculous spondylitic. Magnetic resonance imaging is most helpful planning a surgical approach to tuberculous spondylitis.