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MAGNETIC RESONACE IMAGING FINDINGS IN SPINAL TUBERCULOSIS PHAM QUANG CO CAO THIEN TUONG PHAM NGOC HOA CONTENT     Introduction Study method Results and discussion Conclusion and proposal Introduction  Spinal tuberculosis (Spinal TB):  In  1779, Percival Pott (1714-1788) first described spinal TB The clinical presentations are not pathognomotic A definite diagnosis of spinal TB is ussually late  Prevalence #2%  Sequela: Spinal deformity, compression of spinal cord and nerve roots  Role of radiography, CT scan and other diagnostic methods in order to diagnosing spinal TB are still limited MRI is a best imaging method for diagnosing spinal TB Background Annually, hundreds of spinal TB patients were admitted at department of rheumatology of Choray hospital and about 40 patients with spinal TB were operated at the neurosurgery department of Choray hospital  In order to help early diagnosing this disease, we are performed the subject: “Study of MRI findings in diagnosis of spinal TB at Choray hospital”  Objectives General objective: Study of MRI findings in diagnosis of spinal TB Specific objectives: Evaluate several epidemiological features Demonstrate several common MRI findings of spinal TB Materials and study method Study design: descriptive cross-sectional study Sample size: n = 73 cases Target population: All patients with spinal TB Selection criteria: of criteria - BK(+)/succus or pathological evidence of tuberculosis - Clinical presentation of spinal TB + pulmonary TB, BK(+) - Clinical presentation of spinal TB + response to treatment TB MRI examination is performed Duration: from 01/7/2006 to 31/6/2008 Location: Department of rheumatology and neurosurgery – Choray hospital Methods of data collection: -Review of medical records Protocol MRI of spine at Choray hospital  Sagittal T1W, T2W, STIR, axial T2W, coronal T2W  Axial, Coronal, Sagittal T1W FS + Gd -MRI images are interpreted by two radiologist experienced in MRI Analyse and process data: Data is inputed and processed by SPSS 15.0  Calculate frequency and percentage Results is represented in the form of table and graph  RESULTS and DISCUSSION DISTRIBUTION BY AGE GROUP Highest 41-60, 39,7% Sinan 30%; Stembach USA children+elder DISTRIBUTION BY LESION PATTERNS ON SPINE Sinan 90,9% -Thoracic+lumbar 79,5% -Sinan 79,9% -Al-Muhin 86% DISTRIBUTION BY SITE OF LESIONS Loke 47% > vertebrae DISTRIBUTION BY NUMBER OF INVOLVED VERTEBRAE Sinan 90,9%; Lindahl 4,76%; Joseffer luu y Metas DISTRIBUTION BY PATTERNS OF VERTEBRAL LESIONS Danchaivijitr hủy hoàn toàn 100-81,4%; Tủy 90,3-76,5% -Full loss of structure : 71,2% -Involve disc and vertebra: 89% -Danchaivijitr 80,6-82,4 % -Loke 73% DISTRIBUTION BY NUMBER OF INVOLVED DISCES Cause: Joseffer Seth S: absence of proteolytic enzym; Danchaivijitr compression of spinal cord and nerve roots 80,6% DISTRIBUTION OF SPINAL CORD LESIONS ON MRI DISTRIBUTION BY ABSCESS OF SOFT TISSUES ON MRI Danchaivijitr 96,8-85,3% DISTRIBUTION BY SITE OF PARASPINAL ABSCESS EXTENSION OF ABSCESS FROM INVOLVED VERTEBRA CONCLUSION and PROPOSAL  MRI is the best imaging method for diagnosing spinal TB  Vertebral lesions: continous 93,2%; Thoracic vertebrae 43,8%, lumbar vertebrae 24,7%; Number of involved vertebrae ≥ 3: 46,6%  > 98% vertebrae involve both the endplate and vertebral bodies causing vertebral collapse  Vertebral lesions on MRI: 100% ↓ signal intensity on T1W, heterogenous hyperintensity on T2W and heterogenous-ring enhancement  Spinal TB with compression spinal cord 61,6%, fill in bilateral intervertebral foramina and compression nerve roots 94,6%  Spinal TB with abscess of soft tissuses 98,6%; bilateral paraspinal soft tissues 93%, > abscess foci 97,2% Combined diseases: Diabete 5,4%; pulmonary tuberculosis 4,1%, other tuberculosis 2,8%; immune deficiency 5,4%  Far extension of abscesses 64,4%, perivertebral abscess and compression of dural sac or anteriorlateral epidural abscess 97,2%  Soft tissue lession on MRI: -T1: 98,6% ↓ enhancement -T2: 98,6 % ↑ signal signal + heterogenous-ring PROPOSAL  For definite diagnosis of spinal TB, need to combine with clinical presentation, laboratory tests, imaging modalities and pathology  When suspected spinal TB, MRI should be performed because this is the best imaging method for diagnosis of spinal TB