Study of MRI Morphology of Spinal Tuberculosis

Author(s): D. Venkata Ramana Rao1 , Ramachandra V.2 , Bandlaalle Shohyle3 , Pottala Krishna Mohan4

BACKGROUND Spinal tuberculosis is the infection by Mycobacterium tuberculosis of spine or one or more of its structures namely the vertebra, intravertebral discs, paraspinal soft tissues, and the epidural space. Thoracic vertebrae are commonly affected followed by lumbar and cervical vertebrae. MRI is the method of choice in evaluating spinal infection and their sequelae. We wanted to study the MRI morphology (vertebral body involvement, paravertebral involvement, intraspinal involvement, disc involvement, deformities and sequelae) of spinal tuberculosis. METHODS This is a cross-sectional observational study conducted among patients with suspected spinal tuberculosis, who reported to Department of Radiodiagnosis, GSL Medical College, Rajahmundry. The study was conducted over a period of 18 months. Statistical analysis was performed by SPSS version 21.0 & MS Excel 2013. Informed consent was obtained from all the patients. PHILIPS INGENIA CX which has a super conducting magnet of a magnetic field strength of 1.5 Tesla was used in this study. RESULTS In our study, the most common age group was 20-40 years with a mean age of 54 years. On MRI study, patients showed paraspinal and epidural inflammatory mass, subligamentous spread beneath the anterior longitudinal ligament and skip lesions. Few cases with wedge compression collapse showed gibbus deformity. Single vertebral involvement was seen in very few cases. CONCLUSIONS MRI with its high spatial resolution, multiplanar imaging capability, tissue characterization, is the imaging modality of choice for evaluating suspected cases of spinal tuberculosis. MRI is more sensitive in detecting involvement of posterior elements especially when plain films are normal.