Dr. Hulesh Mandle
Introduction: Many studies have been performed till now and the role of DW- MRI in metastatic spinal involvement has been established. In this study we tried to establish ADC values in cases of spine TB.
Methods: This Retrospective Analytical study involveddata of 200 of the randomly selected patients ( candidates / study subjects).The study was performed in two parts. The first part included all patients of known tuberculosis and patients with classical features of tuberculosis. The second part included patients with spinal pathology of indeterminate etiology. All the patients underwent a routine MRI examination along with diffusion sequences. The apparent diffusion coefficient (ADC) values were calculated from all the involved vertebral bodies.
Results: In total there were 92 vertebrae with high ADC values and 108 vertebrae with low ADC values. Based on all the results obtained we finally calculated that the mean ADC value of 1.39 ± 0.24 × 10-3 mm2 /s had a sensitivity of 63.78% and specificity of 74.53% for predicting spinal tuberculosis. The positive predictive value was 74.48%. Using Fisher’s exact test, the p value was calculated and found to be significant. (p < 0.0001).
Conclusion: DW-MRI and ADC values may help in the differentiation of spinal tuberculosis from other lesions of similar appearance. Diffusion MRI and ADC coefficient values are always best interpreted along with routine MRI sequences and a detailed clinical history and examination.
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