Objective: To describe the magnetic resonance imaging (MRI) characteristics of patients with tuberculous spondylodiscitis treated at Military Hospital 175.
Subjects and Methods: A cross-sectional descriptive study with both retrospective and prospective data collection was conducted on 39 patients with confirmed tuberculous spondylodiscitis at Military Hospital 175 between September 2022 and May 2026.
Results: Lesions were predominantly localized to the lumbar spine (56.4%) and thoracic spine (25.6%), while 17.9% of patients had involvement across adjacent spinal regions. Bone marrow edema and intervertebral disc involvement were observed in all patients (100%). Vertebral body destruction was present in 94.9%, vertebral wedge deformity in 56.4%, intraosseous vertebral abscess in 66.7%, and both paravertebral soft-tissue abscess and posterior element involvement in 97.4% of patients. Involvement of two or more vertebral bodies was observed in 97.4% of patients, whereas epidural lesions were predominantly epidural abscesses (74.4%). Among the 36 assessable cases, the wall of the paravertebral soft-tissue abscess predominantly showed low signal intensity on T1-weighted and T2-weighted images and the ADC map, and high signal intensity on STIR and diffusion-weighted imaging (DWI).
Conclusion: On magnetic resonance imaging, tuberculous spondylodiscitis typically presents with involvement of two or more vertebral bodies, accompanied by vertebral body destruction, intervertebral disc involvement, and paravertebral abscesses. This study also describes the signal characteristics of the paravertebral soft-tissue abscess wall on diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps.