For the evaluation for the diagnostic value of MR imaging in tuberculous spondylitis, twenty-two patients, diagnosed as tuberculous spondylitis histologically and/or bacteriologically, were examined by MR imaging of 1.5T. Various spin echo pulse
sequences were used with TR=250-2500 msec and TE=30-85 msec. The average number of bodies involved per patient was 2.8. Inflammatory tissue showed low signal intensity on T1-weighted image and high signal intensity on T2-weighted image. In all
cases,
the signal intensity increased peripherally after intravenous administration of Gd-DTPA. Regarding the vertebral destruction, destruction of anterior and middle columns was the most. And in all cases, MRI demonstrated variable size of soft tissue
masses. The protrusion of the soft tissue mass into the spinal canal and subligamentous extension of pus or granulation were noted in all cases. The paraverebal mass was distinguished from the adjacent structures with good contrast resolution and
the
route of extension under the paraspinal ligaments was demonstrated well. Although MRI demonstrated excellent images of bone destruction and soft tissue mass, calcification and sequestration were hard to be identified. Despite these disadvantages,
MRI
provides information about the extent of the disease in multiple planes, thereby helping surgeons in planning of the operation. We think that MRI is the most helpful in preoperative planning of surgical approaches of the tuberculous spondylitis.
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