Role of MRI imaging in tuberculous and pyogenic spondylodiscitis

Abstract

Background: MRI has advantage in the diagnosis of spinal infections because of its multiplanar capabilities, soft tissue contrast resolution and delineates extent of disease. The purpose of our study is to identify differences in MR imaging between pyogenic and TB Spondylodiscitis. Methods and Materials: Retrospective analysis of MR Images of 72 patients with confirmed Spondylodiscitis (47 patients with TB Spondylodiscitis and 25 patients with pyogenic Spondylodiscitis). T2, STIR, T1 weighted images (with and without contrast enhancement) were assessed in axial, sagittal and coronal planes. Statistical analysis is by Chi-square test and p value. Result: The main suggestive findings for TB Spondylodiscitis are a) Thin and smooth abscess wall (80.9% TB Spondylodiscitis vs. 4% pyogenic Spondylodiscitis). b) Well defined paraspinal abnormal signal (83% vs. 16%) c) Heterogeneous and focal enhancement of vertebral body (91.5% vs. 8%) d) D) Multi segmental involvement (61.7% vs. 38.3%). The main suggestive findings for Pyogenic Spondylodiscitis are a) Thick and irregular abscess wall (56% in Pyogenic Spondylodiscitis vs. 4.2% in TB Spondylodiscitis). b) Ill-defined paraspinal abnormal signal (76% vs. 8.5%) c) Homogenous and diffuse enhancement of vertebral body (92.0% vs. 8.5%) d) D) Segmental involvement (68% vs. 38.3%) e) E) Disc space narrowing (100% vs.74.5%) Conclusion: Thus MR imaging can differentiate Pyogenic Spondylodiscitis from TB Spondylodiscitis.