MRI of tuberculous spondylitis

Four patients with paravertebral extension of advanced tuberculous intervertebral disk-space infection were studied by CT and MRI. In one patient gadolinium-DTPA (Gd-DTPA) was administered intravenously as a paramagnetic contrast agent. MRI showed the disk-space abnormalities and extension of the inflammatory process to best advantage in the coronal plane. This plane demonstrated in one image the spinal localization and the paravertebral extension of the inflammation. Gd-DTPA assisted in delineating the communication of the vertebral and paravertebral components of inflammation. This phenomenon introduces an additional diagnostic element into the evaluation of spondylitis. Although the features of advanced tuberculous spondylitis are conspicuously well shown with MRI, further experience is needed to evaluate the potential of MRI in detecting early tuberculous spondylitis in relation to nontuberculous spondylitis.