Diagnostic Accuracy of Magnetic Resonance Imaging Findings in Diagnosing Spinal Tuberculosis Taking Histopathology as Gold Standard

Aim: To determine the accuracy of magnetic resonance imaging (MRI) for assessment and diagnosis of spinal TB in suspected patients. Methods: This validation study included 80 suspected cases of spinal TB (Positive Tuberculin skin test (PPD), ESR>100) having age 18 to 65 years, who were referred for MRI evaluation. The study was conducted the radiology department of Ibne-Sienna hospital from January 2020 to September-2020. Initially in all patients, MRI evaluation was done. After that biopsy specimens were took under US guidance and sent for histopathology evaluation. Results: Mean age of study cases was 50 45.1 +/- 9.6 years. Majority, 50(62.5%) patients were men and 30(37.5%) were women. Out of 80 suspected patients, spinal TB was diagnosed in 67 cases on MRI, while on histopathology spinal TB was diagnosed in 64 cases. In remaining 13 patients, 2 patients were diagnosed on spinal TB on histopathology. The sensitivity of MRI was 97.0%, specificity 78.6%, PPV 95.5% and NPV 84.6%. Conclusion: Accuracy of MRI for diagnosing spinal TB is quite high. So MRI should be used as first-line imaging modality in these patients and histopathology should be advised in those patients having strong suspicion of other underlying diseases in these patients.