MRI in differential diagnosis between tuberculous and pyogenic spondylodiscitis

Purpose The aim of the study was to investigate whether MRI findings together with epidemiological data could help in differentiating between tuberculous and pyogenic spondylodiscitis. Methods Clinical records of 260 patients with a suspicion of spondylodiscitis were analysed. Patients were selected...

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Published in:European spine journal 2022-02, Vol.31 (2), p.431-441
Main Authors: Naselli, Nicoletta, Facchini, Giancarlo, Lima, Giacomo Maria, Evangelisti, Gisberto, Ponti, Federico, Miceli, Marco, Spinnato, Paolo
Format: Article
Language:English
Subjects:
Cellulitis
Differential diagnosis
Epidemiology
Epidural
Magnetic resonance imaging
Medicine
Medicine & Public Health
Neurosurgery
Original Article
Patients
Prediction models
Spondylodiscitis
Surgical Orthopedics
Tuberculosis
Vertebrae
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Summary:Purpose The aim of the study was to investigate whether MRI findings together with epidemiological data could help in differentiating between tuberculous and pyogenic spondylodiscitis. Methods Clinical records of 260 patients with a suspicion of spondylodiscitis were analysed. Patients were selected using the following inclusion criteria: confirmed diagnosis of spondylodiscitis either from pyogenic bacteria or from Mycobacterium tuberculosis and contrast-enhanced MRI performed before treatment. Clinical data concerning age, sex and country-of-origin were also collected. For each patient, several MRI-features were evaluated by two-expert musculoskeletal radiologists. A chi-squared test and a multiple logistic regression were used to find the best predictors of tuberculous or pyogenic spondylodiscitis. Results 114 patients were retrospectively enrolled, 30 with tuberculous and 84 with pyogenic spondylodiscitis. We found 18 MRI-features, significantly different between the two groups. Among these, the most strongly associated with tuberculous spondylodiscitis were: heterogeneous vertebral signal on T1w-sequences (Odds Ratio(OR) = 205.759- p  
ISSN:0940-6719
1432-0932
DOI:10.1007/s00586-021-06952-8