Frequency and magnetic resonance imaging patterns of tuberculous spondylitis lesions in adults.

OBJECTIVE To find out the frequency and patterns of various lesions in tuberculous spondylitis in adults on magnetic resonance imaging (MRI). STUDY DESIGN Case series. PLACE AND DURATION OF STUDY Radiology Department, Military Hospital (MH) Rawalpindi, from September 2006 to March 2007. METHODOLOGY Patients with features suggestive of tuberculous spondylitis underwent plain T1- weighted and T2 -weighted images and T1-weighted contrast enhanced images in both axial and sagittal sections. The data was analyzed in terms of frequency and patterns of various lesions of tuberculous spondylitis causing abnormal signals in spinal and paraspinal areas. Mean + standard deviation were calculated for numerical data using SPSS version 15. RESULTS Out of 75 patients, 39 were females. The mean age was 42.4 years. Involvement occurred through SV1 vertebral levels. Most common involvement was seen in the thoracic vertebrae (40%) followed by lumbar vertebrae. The most common MRI feature was abnormal signal intensities appearing hypointense on T1W and hyperintense on T2W sequences with heterogeneous enhancement of the vertebral body in all patients. The characteristic findings of spinal tuberculosis included destruction of two adjacent vertebral bodies and opposing end plates, destruction of intervening disc, and occurrence of paravertebral and epidural abscesses. CONCLUSION MR imaging of spinal tuberculosis, characteristically show contiguous involvement of two vertebrae along with the intervening disc, skip lesions, and paraspinal collections and provides critical information about the involvement of spinal cord and the extent of the disease.