title: Discrimination of tuberculous spondylitis from pyogenic spondylitis on MRI.
abstract: OBJECTIVE
  The purpose of this study was to determine the accuracy of MRI for discrimination between tuberculous spondylitis and pyogenic spondylitis.
  
  
  METHODS
  MR images of 52 patients who had MRI of the spine and confirmed spondylitis were retrospectively reviewed. After review of medical records, we compared MRI findings in 20 patients with tuberculous spondylitis and 20 patients with pyogenic spondylitis. Statistical analysis was performed with the chi-square test.
  
  
  RESULTS
  The reviewer identified tuberculous spondylitis with sensitivity, specificity, and accuracy of 100% (20/20), 80% (16/20), and 90% (36/40), and pyogenic spondylitis with sensitivity, specificity, and accuracy of 80% (16/20), 100% (20/20), and 90% (36/40), respectively. The patients with tuberculous spondylitis had a significantly higher incidence of MRI findings as follows (p < 0.05): a well-defined paraspinal abnormal signal (95% [19/20] in tuberculous vs 25% [5/20] in pyogenic), a thin and smooth abscess wall (95% [19/20] vs 15% [3/20]), combination of both findings (90% [18/20] vs 0% [0/20]), presence of paraspinal or intraosseous abscess (95% [19/20] vs 50% [10/20]), subligamentous spread to three or more vertebral levels (85% [17/20] vs 40% [8/20]), involvement of multiple vertebral bodies (60% [12/20] vs 25% [5/20]), thoracic spine involvement (40% [8/20] vs 10% [2/20]), and hyperintense signal on T2-weighted images (95% [19/20] vs 65% [13/20]).
  
  
  CONCLUSIONS
  MRI was accurate for differentiation of tuberculous spondylitis from pyogenic spondylitis.
authors.affiliation: Department of Diagnostic Radiology, Kangnam St. Mary's Hospital, The Catholic University of Korea, 505 Banpodong, Seocho-ku, Seoul 137-040, Korea.
authors.forename: Na-Young
authors.initials: NY
authors.lastname: Jung
authors.forename: Won-Hee
authors.initials: WH
authors.lastname: Jee
authors.forename: Kee-Yong
authors.initials: KY
authors.lastname: Ha
authors.forename: Chun-Kun
authors.initials: CK
authors.lastname: Park
authors.forename: Jae-Young
authors.initials: JY
authors.lastname: Byun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013166:Spondylitis / Q000175:diagnosis* / Q000382:microbiology*; D013492:Suppuration; D014399:Tuberculosis, Spinal / Q000175:diagnosis*