Abstract:

Objective: To analysis the MRI imaging manifestations and staging of spinal cord tuberculosis. Methods: A retrospective study method was used to include the MRI imaging data of 82 patients who were diagnosed with intracranial tuberculosis combined with spinal cord tuberculosis for the first time at the Third People’s Hospital of Kunming from May 2019 to December 2021 according to the enrollment criteria, to summarize the imaging manifestations and staging. Results: The MRI imaging manifestations of 82 cases of spinal cord tuberculosis were classified into spinal cord parenchymal type (42 cases, 51.2%), spinal meninges type (36 cases, 43.9%), and mixed type (4 cases, 4.9%) according to the involvement or not of spinal membrane and spinal cord parenchyma. Among them, the spinal cord parenchymal type showed the single or multiple nodular enhancing or ring enhancing lesions in the spinal cord parenchyma, with or without spinal cord oedema, and the proportion (64.3% (27/42)) combined with haematogenous disseminated tuberculosis was higher than in the spinal meninges type group (30.6%, 11/36), and was more likely to combine with active secondary tuberculosis (31.0%, 13/42) and tuberculous meningitis (81.0%, 34/42) than that of the spinal meninges type group (61.1%, 22/36 and 97.2%, 35/36, respectively), with statistically significant differences (χ²=8.828, P=0.003; χ²=7.127, P=0.008; χ²=5.027, P=0.025). The spinal meninges type presented linear thickening of the soft spinal cord membrane and/or subarachnoid tuberculoma without spinal cord parenchymal lesions, which might be accompanied with spinal cord oedema, syringomyelia, or subarachnoid adhesions; the mixed type presented both of the above manifestations. Conclusion: Spinal cord tuberculosis is predominantly manifested by MRI of the spinal cord parenchymal type, followed by the spinal meningeal type, while the mixed type is rare, and the diagnostic value of MRI can be enhanced by taking the MRI features of each type as reference.

Key words: Tuberculosis, central nervous system, Spinal cord, Magnetic resonance imaging, Diagnostic imaging