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Skeletal Radiology
Published in: Skeletal Radiology 4/2024

16-10-2023 | Magnetic Resonance Imaging | Scientific Article

Magnetic resonance imaging features for differentiating tuberculous from pyogenic spondylitis: a meta-analysis

Authors: Chen Ling-Shan, Zhu Zheng-Qiu, Li Jing, Zhao Rui, Ling Li-Fang, Wang Zhi-Tao, Wang Zhong-Qiu

Published in: Skeletal Radiology | Issue 4/2024

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Abstract

Objective

To perform a meta-analysis comparing the MRI features of tuberculous and pyogenic spondylitis, using histopathological results and/or blood culture as the standard reference.

Materials and methods

PubMed, Embase, Web of Science, and Cochrane Library were searched for English-language studies on the MRI features of tuberculous and pyogenic spondylitis published between January 2010 and February 2023. Risk for bias and concerns regarding applicability were assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled MRI features’ proportions were calculated using a bivariate random-effects model.

Results

Thirty-two studies met the inclusion criteria: 21 for tuberculous spondylitis, three for pyogenic spondylitis, and eight for both. Of the nine informative MRI features comparing tuberculous spondylitis to pyogenic spondylitis, involvement of ≥ 2 vertebral bodies (92% vs. 88%, P = .004), epidural extension (77% vs. 25%, P < .001), paravertebral collection (91% vs. 84%, P < .001), subligamentous spread (93% vs. 24%, P < .001), thin and regular abscess wall (94% vs. 18%, P < .001), vertebral collapse (68% vs. 24%, P < .001), and kyphosis (39% vs. 3%, P < .01) were more suggestive of tuberculous spondylitis, while disc signal change (82% vs. 95%, P < .001) and disc height loss (22% vs. 59%, P < .001) were more suggestive of pyogenic spondylitis.

Conclusion

Involvement of ≥ 2 vertebral vertebral bodies, soft tissue attribution, thin and regular abscess wall, vertebral collapse, and kyphosis were MRI features more common in tuberculous spondylitis, while disc signal change and height loss were more common in pyogenic spondylitis.
Appendix
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Metadata
Title
Magnetic resonance imaging features for differentiating tuberculous from pyogenic spondylitis: a meta-analysis
Authors
Chen Ling-Shan
Zhu Zheng-Qiu
Li Jing
Zhao Rui
Ling Li-Fang
Wang Zhi-Tao
Wang Zhong-Qiu
Publication date
16-10-2023
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 4/2024
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-023-04459-5

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