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Date Published: 16/05/2025
Abstract Views: 76
Views PDF: 13
DOI: https://doi.org/10.55046/vjrnm.4.1317.2024
Issue
No. 4 (2024): Tiếng anh
Section
Scientific research
How to Cite
Dau , T. P. N., Pham , M. T., Nguyen , T. T. H., Dam , T. T., & Pham , M. C. (2024). MAGNETIC RESONANCE IMAGING FINDINGS FEATURES FOR DIFFERENTIATING TUBERCULOUS AND PYOGENIC SPONDYLODISCITIS. Vietnamese Journal of Radiology and Nuclear Medicine, 4, 25-31. https://doi.org/10.55046/vjrnm.4.1317.2024

MAGNETIC RESONANCE IMAGING FINDINGS FEATURES FOR DIFFERENTIATING TUBERCULOUS AND PYOGENIC SPONDYLODISCITIS

Dau Thi Phuong Nhi1, , Pham Minh Thong1, Nguyen Thi Thu Hang2, Dam Thuy Trang2, Pham Manh Cuong2
1 Hanoi Medical University
2 Radiology Center, Bach Mai Hospital

Main Article Content

Abstract

Objectives: Differentiating tuberculous spondylodiscitis (TBSD) from pyogenic spondylodiscitis (PSD) remains a diagnostic challenge due to the low positivity rates in microbiological and histopathological tests. This study aimed to determine MRI imaging features that can help distinguish between TBSD and PSD.
Methods: A retrospective study was conducted on patients diagnosed with SD (either by microbiological, histopathological findings, or treatment response), who had undergone contrast-enhanced MRI scans of the spine before treatment. Imaging features on MRI were described and compared between TBSD and PSD group.
Results: A total of 65 patients were studied, including 23 (35.4%) with TBSD and 42 (64.6%) with PSD. Of the 13 MRI features analyzed, 8 showed significant differences between the two groups (p<0.05). Features indicative of TBSD: Thoracic spine involvement (OR=8.073), vertebral body destruction >50% height loss (OR=21.867), presence of intraosseous abscess (OR=4.604), disc preservation (OR=8.217), thin and smooth-walled paravertebral abscess (OR=11.511). Features indicative
of PSD: Lumbar-sacral spine involvement (OR=5.681), epidural abscess formation (OR=7.752), thick and irregular-walled paravertebral abscess (OR=21.739).
Conclusion: Several MRI features can help differentiate between TBSD and PSD, guiding appropriate treatment selection, particularly when microbiological confirmation is unavailable.

Keywords

Magnetic resonance imaging, spine, spondylodiscitis, tuberculosis, pyogenic.

Article Details

References

1. Zimmerli, W. Clinical Practice. Vertebral Osteomyelitis. N. Engl. J. Med. 2010, 362 (11), 1022–1029. https://doi. org/10.1056/NEJMcp0910753.
2. Kumar, Y.; Gupta, N.; Chhabra, A.; Fukuda, T.; Soni, N.; Hayashi, D. Magnetic Resonance Imaging of Bacterial and Tuberculous Spondylodiscitis with Associated Complications and Non-Infectious Spinal Pathology Mimicking Infections: A Pictorial Review. BMC Musculoskelet. Disord. 2017, 18 (1), 244. https://doi.org/10.1186/s12891-017- 1608-z.
3. Jung, N.-Y.; Jee, W.-H.; Ha, K.-Y.; Park, C.-K.; Byun, J.-Y. Discrimination of Tuberculous Spondylitis from Pyogenic Spondylitis on MRI. AJR Am. J. Roentgenol. 2004, 182 (6), 1405–1410. https://doi.org/10.2214/ajr.182.6.1821405.
4. CT-Guided Biopsy in Suspected Spondylodiscitis – The Association of Paravertebral Inflammation with Microbial Pathogen Detection - PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699662/ (accessed 2023-07-31).
5. The Efficacy of Computed Tomography-Guided Percutaneous Spine Biopsies in Determining a Causative Organism in Cases of Suspected Infection: A Systematic Review - Madeleine Sertic, Leighanne Parkes, Sabrina Mattiassi, Kenneth Pritzker, Michael Gardam, Kieran Murphy, 2019. https://journals.sagepub.com/doi/full/10.1016/j. carj.2018.09.003 (accessed 2023-07-31).
6. Ahuja, N.; Sharma, H. The Effectiveness of Computed Tomography-Guided Biopsy for the Diagnosis of Spondylodiscitis: An Analysis of Variables Affecting the Outcome. Eur. Rev. Med. Pharmacol. Sci. 2017, 21 (9), 2021–2026.
7. Kim, C.-J.; Kim, E. J.; Song, K.-H.; Choe, P. G.; Park, W. B.; Bang, J. H.; Kim, E. S.; Park, S. W.; Kim, H.-B.; Oh, M.; Kim, N. J. Comparison of Characteristics of Culture-Negative Pyogenic Spondylitis and Tuberculous Spondylitis: A Retrospective Study. BMC Infect. Dis. 2016, 16 (1), 560. https://doi.org/10.1186/s12879-016-1897-0.
8. Chang, M.-C.; Wu, H. T. H.; Lee, C.-H.; Liu, C.-L.; Chen, T.-H. Tuberculous Spondylitis and Pyogenic Spondylitis: Comparative Magnetic Resonance Imaging Features. Spine 2006, 31 (7), 782–788. https://doi.org/10.1097/01. brs.0000206385.11684.d5.
9. Harada, Y.; Tokuda, O.; Matsunaga, N. Magnetic Resonance Imaging Characteristics of Tuberculous Spondylitis vs. Pyogenic Spondylitis. Clin. Imaging 2008, 32 (4), 303–309. https://doi.org/10.1016/j.clinimag.2007.03.015.
10. Frel, M.; Białecki, J.; Wieczorek, J.; Paluch, Ł.; Dąbrowska-Thing, A.; Walecki, J. Magnetic Resonance Imaging in Differentatial Diagnosis of Pyogenic Spondylodiscitis and Tuberculous Spondylodiscitis. Pol. J. Radiol. 2017, 82, 71–87. https://doi.org/10.12659/PJR.899606.