Utility and Accuracy of Magnetic Resonance Imaging in the Diagnosis of Tubercular Spondylodiscitis

Abstract

Objective: To evaluate the utility and accuracy of magnetic resonance imaging (MRI) in the diagnosis of spinal infections, in particular tubercular spondylodiscitis. Methods: This was a hospital based retrospective study conducted in the Department of Radiodiagnosis, Meenakshi Medical College Hospital and Research Institute, Kanchipuram district, Tamil Nadu, India between February 2023, and February 2024 among patients referred to the Department for MRI, with a clinical diagnosis of spinal infections. Results: The present study enrolled a total of 25 patients with a clinical diagnosis of spinal infections referred to the Department of Radiodiagnosis. The mean (SD) age of the patients was 61.0 years (5.4); ranging between 55 years and 65 years. The proportion of males and females were 64.0% and 36.0% respectively (ratio of 16:9). Of the 25 patients, 22 (88.0%) patients were radiologically diagnosed with tubercular spondylitis on the basis of MRI findings. The other three patients were diagnosed with infective etiology – possibly tubercular. Based on the site of spinal involvement, it was noted that the cervical, dorsal-lumbar, dorsal, and lumbar involvement were 12.0%, 40.0%, 28.0%, and 20.0%, respectively. The complications of spinal involvement was also noted – 72.0% had epidural extension, 56.0% had cord compression, 48.0% had spinal deformity, 28.0% had myelitis, 16.0% had intramedullary lesions, and 8.0% had sinus tracts. All the patients underwent confirmatory diagnosis with either histopathology and/or cytology and/or culture and/or biochemistry and/or with successful therapeutic outcome; the results showed that 24 (96.0%) cases were of tubercular etiology. The sensitivity of MRI was found to be 96.4% and the specificity was found to be 89.0%. Conclusion: The study underscores the pivotal role of MRI in the comprehensive evaluation of spinal infections, facilitating timely diagnosis, appropriate management, and improved patient outcomes.