EVALUATION OF DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING AGAINST CONTRAST ENHANCED MAGNETIC RESONANCE IMAGING IN DIAGNOSIS OF SPINAL TUBERCULOSIS.
Journal Title: INTERNATIONAL JOURNAL OF ADVANCED MEDICINE - Year 2017, Vol 1, Issue 2
Abstract
Background: Tuberculosis is a very important health issue in the developing countries. The spinal tuberculosis is characterised by intervertebral disc involvement, pre/paravertebral and epidural abscess formation, skip lesions with destruction and collapse of the vertebral bodies leading to spinal deformity. RI is the investigation of choice for the diagnosis of spinal tuberculosis because it provides excellent soft tissue contrast with multiplanar imaging capability leading to better evaluation of bone marrow and neural structures. Presently contrast enhanced MRI is the gold standard modality for clinching the diagnosis of Pott's spine which shows the vertebral bodies and intervertebral disc enhancement in the affected area with associated pre and Para-vertebral soft tissue component or abscess. Diffusion weighted imaging (DWI) has emerged as a promising tool in evaluation of spinal TB. Methods: MRI scans of 50 suspected cases of spinal tuberculosis visiting the place of study were studied prospectively. Results: The 94 % cases showed contrast enhancement. Restriction of diffusion with correspondingly low ADC values were seen in 30% cases. Conclusion: The CE MRI continues to be the gold standard imaging modality for Pott's spine. However, DWI may emerge as a useful adjunct to conrm the diagnosis in equivocal cases after further research on its utility.Background: Tuberculosis is a very important health issue in the developing countries. The spinal tuberculosis is characterised by intervertebral disc involvement, pre/paravertebral and epidural abscess formation, skip lesions with destruction and collapse of the vertebral bodies leading to spinal deformity. RI is the investigation of choice for the diagnosis of spinal tuberculosis because it provides excellent soft tissue contrast with multiplanar imaging capability leading to better evaluation of bone marrow and neural structures. Presently contrast enhanced MRI is the gold standard modality for clinching the diagnosis of Pott's spine which shows the vertebral bodies and intervertebral disc enhancement in the affected area with associated pre and Para-vertebral soft tissue component or abscess. Diffusion weighted imaging (DWI) has emerged as a promising tool in evaluation of spinal TB. Methods: MRI scans of 50 suspected cases of spinal tuberculosis visiting the place of study were studied prospectively. Results: The 94 % cases showed contrast enhancement. Restriction of diffusion with correspondingly low ADC values were seen in 30% cases. Conclusion: The CE MRI continues to be the gold standard imaging modality for Pott's spine. However, DWI may emerge as a useful adjunct to conrm the diagnosis in equivocal cases after further research on its utility.
Authors and Affiliations
Yadav K Vijay, Sharma Pankaj, Chatterjee Samar, Maheshwari Saurabh
Keywords
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