The challenges in differentiating tuberculous from pyogenic spondylitis using magnetic resonance imaging
Authors Yueniwati Y, Christina E
Received 6 December 2016
Accepted for publication 1 June 2017
Published 30 June 2017 Volume 2017:10 Pages 37—43
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Akshita Wason
Peer reviewer comments 3
Editor who approved publication: Professor Tarik Massoud
Yuyun Yueniwati, Evelyn Christina
Radiology Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia
Purpose: To analyze the diagnostic value of MRI for distinguishing tuberculous from pyogenic spondylitis confirmed by histology results and to determine the cut-off point score of MRI.
Subjects and methods: Observational analytic design with a cross-sectional approach. Data were collected from radiology and pathology anatomy medical records, therefore no informed consent was obtained. We utilized diagnostic tests using 2×2 tables and receiver operating characteristic curve to obtain the value of the sensitivity, specificity, accuracy, and area under curve (AUC) of MRI. Twenty-eight samples were selected, consisting of 20 samples of tuberculous spondylitis and 8 samples of pyogenic spondylitis.
Results: The radiological diagnosis using MRI had a sensitivity of 85%, specificity of 87.5%, positive predictive value of 94.4%, negative predictive value of 70%, and accuracy of 85.7%. AUC value was 91.6%, p = 0.001. MRI with a score ≥4 had sensitivity of 90%, specificity of 87.5%, positive predictive value of 94.7%, negative predictive value of 77.8%, and accuracy of 89.2%.
Conclusion: MRI had a high diagnostic value with AUC value of 91.6% for distinguishing tuberculous from pyogenic spondylitis, confirmed by histology results. MRI, with a score of ≥4, had a higher diagnostic value compared with the reading of MRI without using scores.
Keywords: histology, MRI, pyogenic spondylitis, tuberculous spondylitis
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]