SPECTRUM OF MRI FINDINGS IN SPINAL TUBERCULOSIS
Objective: Tuberculosis caused by mycobacterium tuberculosis is among the commonest diseases around the world
especially in third world countries and tuberculosis of the spine is the commonest extra pulmonary manifestation of the
disease. MR imaging is usually performed to evaluate symptomatic patients. The purpose of this article is to evaluate
the typical and atypical findings of spinal tuberculosis on MR imaging.
Material and Methods: The study is a cross sectional study. The study was conducted in Peshawar Institute of Medical
Sciences from 1st January 2015 to 1st November 2015 during which 58 cases of patients with tuberculous spine were
evaluated with MRI and the different imaging features were analyzed.
Results: Spinal tuberculosis is a very common disease presenting usually with typical imaging findings but at times
the presentation can be quiet atypical. The important findings of spinal TB on MRI are endplate disruption (found in 56
out of 58 patients in our study), paravertebral soft tissue abscess (48 patients) and the presence of increased signal
intensity of intervertebral disc on T2WI (53 patients). In addition, MRI will identify other abscesses including extension
into the psoas muscle (40 patients) and epidural space (33 patients), posterior element involvement (2 patients) and
spinal cord compression (17 patients). MRI is also able to identify any resultant spinal deformity like gibbus formation
(5 patients), vertebra plana (5 patients) etc. Atypically more than two contiguous vertebrae can be involved (3 patients).
Conclusion: MRI is the best diagnostic modality for spinal TB and is more sensitive than other modalities. It provides
the diagnosis earlier than conventional methods, offering the benefits of earlier detection and treatment. MRI allows for
rapid determination of the mechanism for neurologic compression and can distinguish between bone and soft tissue
lesion. MRI with contrast is helpful in differentiating from noninfectious causes and delineating the extent of disease.
MRI can identify the typical and atypical presentations of the disease.
Key Words: Tuberculosis, Potts spine, Magnetic resonance imaging.