Title: MR Imaging Features of Tuberculosis of the Spine
Authors: Dr Rohini Avantsa, Dr Prachi Kala, Dr Vidya Bhargavi
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.87
Abstract
Background: Spinal tuberculosis is most common form of skeletal tuberculosis. Radiological findings mimic many other infections and spinal diseases. Understanding the pattern of infection, early detection of the disease is important to prevent the complications and disability, and MRI is the imaging modality of choice for diagnosing spinal infections and is promising diagnostic modality in patients with suspected spinal tuberculosis. The purpose of the study is to describe features of spinal tuberculosis (TB) on magnetic resonance imaging (MRI), extent of disease and complications.
Methods: MR images of 40 patients with proven Spinal Tuberculosis were retrospectively analyzed and results were tabulated.
Results: The majority of the patients were males (n=28) and are above 40 years age group (60%). The most common clinical presentation was pain (83%). The lumbar spine was the commonest site of the disease (27.5%) followed by thoracic region (22.5%). Typical presentation was most frequently observed (87.5%) and skip lesions were more among the atypical presentation (80%). 40% cases are associated with complications and most frequent complication observed was compressive myelopathy (43.75%).
Conclusions: MRI is highly sensitive in the detecting spinal tuberculosis at various stages of disease process , their pattern of occurrence and soft tissue involvement.
Keywords: Spinal tuberculosis, Magnetic resonance imaging, skip lesions, contiguous, Epidural, Psoas.
References
1. Fain O,Lortholary O,Lascaux V,et al.Extra pulmonary tuberculosis in the northeastern suburbs of Paris: 141 cases. Eur J Intern Med 2000;11:145-150.
2. Srikanth Moorthy, Nirmal K.Prabhu.Spectrum of MR imaging findings in Spinal Tuberculosis. AJR Am J Roentgenol 2002;179:979-983.
3. Lauzardo M,Ashkin D,:Phthisiology at the dawn of the new century. Chest 2000;117:1455-1473.
4. Paradisi F, Corti G, Skeletal tuberculosis and other granulomatous infections. Baillieres Best Pract Res Clin Rheumatol 199; 13:163-177.
5. Moore S.L, Rafil M. Imaging of musculoskeletal and spinal Tuberculosis. Radiol Clin North America 2001;39:329-342.
6. Rivas-Garcia A, Sarria-Estrada S, Torrents-Odin C, Casas-Gomila L, Franquet E. Imaging findings of Pott’s disease. European Spine Journal 2013;22(Suppl 4):567-578.
7. Blanco R, Ojala R, Kariniemi J, Niinimaki J, Tervonen O. Interventional and intraoperative MRI at low field scanner, a review. Eur J Radiol 2005;56:130–142
8. Cormican L, Hammal R, Messenger J, Milburn HJ. Current difficulties in the diagnosis and management of spinal tuberculosis. Postgrad Med J. 2006;82:46–51.
9. Lederman HP, Schweitzer ME, Morrison WB, Carrino JA. MR imaging findings in spinal infections:Rules or myths? Radiology 2003;228:506-514.
10. ShanleyDJ.Tuberculosis of the spine:imaging features.AJR AmJ Roentgenol.1995;164:659-664.
11. Kotzé DJ, Erasmus LJ. MRI findings in proven Mycobacterium tuberculosis (TB) spondylitis. South African Journal of Radiology. 2006;10(2):6–12.
12. Ansari S, Rauniyar RK, Dhungel K, et al. MR evaluation of spinal tuberculosis. Al Ameen J Med Sci. 2013;6(3):219-25.
13. Dharmalingam M. Tuberculosis of the spine-Sabah experience. Epidemiology, treatment and results, Tuberculosis 2004; 84:24-28.
14. Khalequzzaman S1, Hoque HW2 et al: Tuberculosis of Spine Magnetic Resonance Imaging (MRI) Evaluation of 42 Cases. Medicine today.2012;24(2): 59-62.
15. Loke TK, Ma HTG, Chan CS. Magnetic Resonance Imaging of the Tuberculous spinal infection. Austral as Radiol 1997;4:7-12.
16. Lolge S, Maheshwari M, Shah J, Patkar D, Chawla A. Isolated solitary vertebral body tuberculosis-study of seven cases. Clin Radiol 2003; 58:545-50.
17. Smith AS, Weinstein MA, Mizushima A, Coughlin B, Hayden SP et al. MR imaging characteristics of Tuberculous spondylitis vs vertebral osteomyelitis, AJR 1989;153:399-405.
18. J. Breckling, Ed., The Analysis of Directional Time Series: Applications to Wind Speed and Direction, ser. Name of the journal , year, Vol..No.
19. S. Zhang, C. Zhu, J. K. O. Sin, and P. K. T. Mok, “A novel ultrathin elevated channel low-temperature poly-Si TFT,” journal name., vol. 20, pp. 569–571, Nov. 1999