Role of Gene Xpert MTB/RIF assay for detecting tuberculous spondylitis in specimens obtained by CT-guided aspiration/biopsy and spectrum of imaging findings in spinal tuberculosis

Q3 Medicine

Indian Journal of Tuberculosis Pub Date : 2025-01-01 DOI:10.1016/j.ijtb.2023.10.007

Richa Misra , Anil Kumar Singh , Zafar Neyaz , Vivek Kumar Singh , Vimal K. Paliwal , Prabhakar Mishra

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引用次数: 0

Abstract

Objective

To evaluate the utility of the GeneXpert MTB/RIF assay for the diagnosis of tuberculous spondylitis in samples obtained by CT-guided aspiration/biopsy. The effect of anti-tubercular treatment, specimen type, and imaging findings on laboratory results was also assessed along with a comparison of imaging findings in tubercular versus non-tubercular cases.

Methods

This prospective observational study, planned for CT-guided aspiration/ biopsy, included 70 adults with suspected tuberculous spondylitis. Specimens were sent for microscopy, histopathology, TB culture, and Gene Xpert MTB/RIF assay. The correlation of sampling location, specimen type, anti-tubercular treatment, and imaging findings on microbiology results was documented.

Results

A definite diagnosis of tuberculous spondylitis was obtained in 50 cases. The assay had a 100 % agreement for smear-positive, culture-positive, specimens while the overall agreement was 41.3 %. Rifampicin resistance was detected in 8 cases. Seventy-one percent of patients were on empiric ATT. Imaging findings such as end plate destruction, paravertebral soft tissue thickening and abscess, disc involvement, sequestrum, and bony fragments were significantly associated with a final diagnosis of spinal tuberculosis.

Conclusions

The Gene Xpert MTB/RIF assay performed on specimens obtained by CT-guided aspiration/biopsy is a sensitive and rapid method of establishing a diagnosis of tuberculous spondylitis even in cases on ATT.

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基因Xpert MTB/RIF检测在ct引导下的抽吸/活检和脊柱结核的影像学表现中检测结核性脊柱炎的作用

目的评价GeneXpert MTB/RIF检测在ct引导下抽吸/活检样本中诊断结核性脊柱炎的应用价值。还评估了抗结核治疗、标本类型和影像学结果对实验室结果的影响，并比较了结核病例和非结核病例的影像学结果。该前瞻性观察研究计划采用ct引导下的穿刺/活检，纳入了70例疑似结核性脊柱炎的成人。标本送去显微镜检查、组织病理学检查、结核培养和基因Xpert MTB/RIF检测。记录了采样位置、标本类型、抗结核治疗和微生物学成像结果的相关性。结果50例结核性脊柱炎得到明确诊断。该分析对涂片阳性、培养阳性标本的一致性为100%，而总体一致性为41.3%。8例检测到利福平耐药。71%的患者接受了经验性ATT治疗。影像学表现如终板破坏、椎旁软组织增厚和脓肿、椎间盘受累、残骨和骨碎片与脊柱结核的最终诊断显著相关。结论Gene Xpert MTB/RIF检测是一种灵敏、快速的诊断结核性脊柱炎的方法，即使在结核性脊柱炎病例中也是如此。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian Journal of Tuberculosis Medicine-Infectious Diseases

CiteScore

2.80

自引率

0.00%

发文量

103

期刊介绍： Indian Journal of Tuberculosis (IJTB) is an international peer-reviewed journal devoted to the specialty of tuberculosis and lung diseases and is published quarterly. IJTB publishes research on clinical, epidemiological, public health and social aspects of tuberculosis. The journal accepts original research articles, viewpoints, review articles, success stories, interesting case series and case reports on patients suffering from pulmonary, extra-pulmonary tuberculosis as well as other respiratory diseases, Radiology Forum, Short Communications, Book Reviews, abstracts, letters to the editor, editorials on topics of current interest etc. The articles published in IJTB are a key source of information on research in tuberculosis. The journal is indexed in Medline