[Contribution of spiral CT scan and MRI in spinal tuberculosis]

Spinal tuberculosis is the most frequent skeletal involvement in tuberculosis. The purpose of this study was to demonstrate the importance of the MRI and the helicoidal CT scan in the diagnosis of spinal tuberculosis. A retrospective study was conducted in 23 patients with spinal tuberculosis. The methods of investigation were helicoidal CT scan in 15 patients and MRI in the other eight patients. In the all cases with helicoidal CT scan, the features of the spinal tuberculosis were seen as an anterior vertebral body destruction with a paraspinal or epidural extension in 12 cases and a sequestrum formation in 5 cases. The analysis with helicoidal CT scan showed a gibbous deformity in 5 cases, a disk space narrowing in 14 cases and evaluated the extension very well. The MR imaging features showed one case in an early stage without features on the plain radiographs, and detected 3 cases of intramedullary lesions. A disruption of the longitudinal posterior vertebral ligament was found in one case and skip lesions at the granulomatous stage in 2 cases. MRI is superior to CT scan even helicoidal CT at the early lesion stage, skip lesions and the ligamentous or medullary lesions. For other lesions (bone, disk, extension), the MRI and CT scan are the same with an advantage for CT scan in osseous lesions.