Research Paper

Evaluation Of Diffusion Weighted Magnetic Resonance Imaging Against Contrast Enhanced Magnetic Resonance Imaging In Diagnosis Of Spinal Tuberculosis.

Abstract :

Background: Tuberculosis is a very important health issue in the developing countries. The spinal tuberculosis is characterised by interverteal disc involvement, pre/paraverteal and epidural abscess formation, skip lesions with destruction and collapse of the verteal 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 verteal bodies and interverteal disc enhancement in the affected area with associated pre and Para-verteal 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 Potts spine. However, DWI may emerge as a useful adjunct to confirm the diagnosis in equivocal cases after further research on its utility.

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