MR spectroscopy findings in tuberculous spondylitis; comparison with Modic type-I end-plate changes and metastatic vertebral disease

Purpose: To define single-voxel proton magnetic resonance spectroscopy (MRS) findings of vertebral tuberculous spondylitis (TBS), Modic type-I end-plate changes (MTEC) and metastatic vertebral disease (MVD). Materials and methods: Fifteen patients with TBS, 15 with MTEC and 15 with MVD were included. MRS from the diseased vertebral body as well as normal vertebral body was examined. Water and lipid peak were measured, water-to-lipid ratio (WLR) and for each patient lesion water index (LWI, the ratio of WLRs from diseased to normal vertebrae) were calculated. Results: The mean WLR of normal and pathologic vertebra was 0.91 and 7.13 in TBS group, 0.84 and 3.49 in MTEC group and 0.65 and 3.17 in MVD group, respectively. The mean LWI was 10.68 in TBS, 6.04 in MTEC and 6.42 MVD groups. Statistical significance was not achieved between the WLR and LWI of the TBS, MTEC nor MVD group (p > 0.05). Conclusion: The mean values of WLR and LWI in the TBS group are relatively higher than MTEC and MVD groups, with the difference being statistically insignificant.