Kesesuaian Hasil Pemeriksaan Foto Radiografi Vertebra dan MRI Vertebra dengan GENE XPERT MTB dalam Menegakkan Diagnosis Spondilistis Tuberculosis
DOI:
https://doi.org/10.35730/jk.v14i0.1127Abstract
Diagnosis spondilitis tuberkulosis umumnya terlambat karena manifestasi awal yang tidak spesifik dengan tingkat kecurigaan yang rendah. Pendekatan diagnostik didasarkan pertimbangan klinis, pencitraan radiologi dan prosedur yang tepat untuk mendapat sampel bakteriologis, patologis atau informasi molekular. Penelitian ini bertujuan untuk mengetahui kesesuaian hasil pemeriksaan foto radiografi vertebra dan MRI vertebra dengan GeneXpert MTB dalam menegakkan diagnosis spondilitis tuberkulosis (kasus lanjut). Penelitian ini dilaksanakan di Departemen Radiologi RSUP dr. Wahidin Sudirohusodo Makassar. Jumlah sampel sebanyak 28 sampel yang masuk kriteria inklusi.Penilaian destruksi corpus vertebra, penyempitan discus intervertebralis, massa paravertebra dan keterlibatan multilevel corpus vertebra didasarkan pemeriksaan foto radiografi vertebra. Penilaian edema corpus vertebra, destruksi corpus vertebra, penyempitan discus intervertebralis, keterlibatan multilevel corpus vertebra, abses paravertebra, keterlibatan canalis spinalis dan angulasi posterior didasarkan pemeriksaan MRI vertebra. Selanjutnya, dilakukan penilaian kesesuaian hasil foto radiografi vertebra dan MRI vertebra dengan hasil GeneXpert MTB kesan terdeteksi Mycobacterium MTB. Hasil penelitian menunjukkan tingkat kesesuaian paling tinggi pada pemeriksaan foto radiografi vertebra dengan GeneXpert yaitu gambaran destruksi corpus vertebra (96,4%). Tingkat kesesuaian paling tinggi pada pemeriksaan MRI vertebra tanpa kontras dengan GeneXpert yaitu gambaran destruksi corpus vertebra dan abses paravertebra (96,4%), diikuti oleh keterlibatan multilevel corpus vertebra (92,9%), penyempitan discus intervertebralis (89,3%), keterlibatan canalis spinalis (85,7%), angulasi posterior (82.1%) dan edema corpus vertebra (35,7%).
References
Hidalgo, J.A., Alangaden G. 2022. Pott disease tuberculosis spondylitis. Emedicine.
Rahyussalim, Kurniawati T, Harinda F, Gunawan C, Graciana T, Jonlean R, et al. (2018) Spondilitis Tuberkulosis: Diagnosis, tatalaksana dan rehabilitasi. 1st edn. Jakarta, Jakarta: Media Aesculapius.
Chilkoti, G.T., Jain, N., Mohta, M. and Saxena, A.K., 2020. Perioperative concerns in Pott's spine: A review. Journal of Anaesthesiology, Clinical Pharmacology, 36(4), p.443.
Negi, S.S., Gupta, S., Khare, S. and Lal, S., 2005. Comparison of various microbiological tests including polymerase chain reaction for the diagnosis of osteoarticular tuberculosis. Indian journal of medical microbiology, 23(4), pp.245-248.
Garg, R.K. and Somvanshi, D.S., 2011. Spinal tuberculosis: a review. The journal of spinal cord medicine, 34(5), pp.440-454
Sharma, A., Chhabra, H.S., Mahajan, R., Chabra, T. and Batra, S., 2016. Magnetic resonance imaging and GeneXpert: a rapid and accurate diagnostic tool for the management of tuberculosis of the spine. Asian Spine Journal, 10(5), p.850.
Danchaivijitr, N., Temram, S., Thepmongkhol, K. and Chiewvit, P., 2007. Diagnostic accuracy of MR imaging in tuberculous spondylitis. JOURNAL-MEDICAL ASSOCIATION OF THAILAND, 90(8), p.1581.
Jain, A.K., Sreenivasan, R., Saini, N.S., Kumar, S., Jain, S. and Dhammi, I.K., 2012. Magnetic resonance evaluation of tubercular lesion in spine. International orthopaedics, 36(2), pp.261-269.
Held, M., Laubscher, M., Zar, H.J. and Dunn, R.N., 2014. GeneXpert polymerase chain reaction for spinal tuberculosis: an accurate and rapid diagnostic test. The bone & joint journal, 96(10), pp.1366-1369.
Adam, R.D., Victor, M., Ropper, A.H. 2012. Principle of Neurology,6th ed. New York: Mc Graw-Hill,
Mardjono, M., Sidarta, P. 2000. Neurologi Klinis Dasar, cetakan VIII : Dian Rakyat, Jakarta. Hal 95-104. Burgener,F.A., Kormano, M. 1999. Differential Diagnosis in Computed Tomography. Thieme. New York USA. Hal 120-22.
Rad A, Osika A., 2022. Vertebral column. Kenhub. Accessed from https://www.kenhub.com/en/library/anatomy/the-vertebral-column-spine
Highsmith J.M. 2020. Spinal Anatomy Center. Accessed from https://www.spineuniverse.com/anatomy
Wong A, El-Feky M, Hacking C, et al. 2020. Cervical spine ligaments. Reference article, Radiopaedia. Accessed from https://radiopaedia.org/articles/cervical-spine-ligaments-1
Snell, R.S., 2011. Clinical anatomy by regions. Lippincott Williams & Wilkins.
Raj,P.P., 2008. Intervertebral disc:anatomy physiology pathophysiology treatment. Pain Practice, 8(1), pp.18-44
Vuong, S.M., Jeong, W.J., Morales, H. and Abruzzo, T.A., 2016, October. Vascular diseases of the spinal cord: infarction, hemorrhage, and venous congestive myelopathy. In Seminars in Ultrasound, CT and MRI (Vol. 37, No. 5, pp. 466-481). WB Saunders.
Abdeen, K., 2006. Surgery for tuberculosis of the cervical spine. The Internet Journal of Neurosurgery, 3(2).
Andronikou, S., Jadwat, S. and Douis, H., 2002. Patterns of disease on MRI in children with tuberculous spondylitis and the role of gadolinium. Pediatric radiology, 32(11), pp.798-805.
Smith, I., 2003. Mycobacterium tuberculosis pathogenesis and molecular determinants of virulence. Clinical microbiology reviews, 16(3), pp.463-496.
Solomon, L., Warwick, D. and Nayagam, S. eds., 2010. Apley's system of orthopaedics and fractures. CRC press.
Vuyst, D.D., Vanhoenacker, F., Gielen, J., Bernaerts, A. and Schepper, A.M.D., 2003. Imaging features of musculoskeletal tuberculosis. European radiology, 13(8), pp.1809-1819.
Salter, R.B., 1999. Textbook of disorders and injuries of the musculoskeletal system: An introduction to orthopaedics, fractures, and joint injuries, rheumatology, metabolic bone disease, and rehabilitation. Lippincott Williams & Wilkins.
McLain, R.F. and Isada, C., 2004. Spinal tuberculosis deserves a place on the radar screen. Cleveland Clinic journal of medicine, 71(7), pp.537-9.
Rivas-Garcia, A., Sarria-Estrada, S., Torrents-Odin, C., Casas- Gomila, L. and Franquet, E., 2013. Imaging findings of Pott’s disease. European Spine Journal, 22(4), pp.567-578
Teo E.L., Peh W.C. 2004. Imaging of tuberculosis of the spine. Pictorial essay. Singapore Med j, p.440
Ledermann, H.P., Schweitzer, M.E., Morrison, W.B. and Carrino, J.A., 2003. MR imaging findings in spinal infections: rules or myths?. Radiology, 228(2), pp.506-514
Kotze, D.J. and Erasmus, L.J., 2006. MRI findings in proven Mycobacterium tuberculosis (TB) spondylitis. SA Journal of Radiology, 10(2), pp.6-12.
Currie, S., Galea-Soler, S., Barron, D., Chandramohan, M. and Groves, C., 2011. MRI characteristics of tuberculous spondylitis. Clinical radiology, 66(8), pp.778-787
Palomino, J.C., 2005. Nonconventional and new methods in the diagnosis of tuberculosis: feasibility and applicability in the field. European Respiratory Journal, 26(2), pp.339-350.
Wulandari, Y., Wiqoyah, N. and Mertaniasih, N.M., 2011. Nucleic acid amplification of the RPOB region of Mycobacterium tuberculosis in pulmonary tuberculosis diagnosis. Folia Medica Indonesiana, 47(04), pp.224-229
Singh, K.K., Muralidhar, M., Kumar, A., Chattopadhyaya, T.K., Kapila, K., Singh, M.K., Sharma, S.K., Jain, N.K. and Tyagi, J.S., 2000. Comparison of in house polymerase chain reaction with conventional techniques for the detection of Mycobacterium tuberculosis DNA in granulomatous lymphadenopathy. Journal of clinical pathology, 53(5), pp.355-361.
World Health Organization, 2013. Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB (No. WHO/HTM/TB/2013.16). World Health Organization.
Wardoyo EH, Cenderadewi M, Rahman H, Putri NA, Purnaning D. Karakteristik spondilitis tuberculosis di Rsup NTB Januari-Desember 2012. Indonesia J Infect Dis. 2017 Nov 5;2(2):20-3.
Mijaya YI, Sahetapy CM, Kusmana DA. Profil Pasien Spondilitis Tuberkulosis (Pott’s Disease) di Rumah Sakit Pusat Angkatan Darat Gatot Soebroto. Majalan Kedokteran UKI Vol XXXVI No 2. 2020
Iseman, M. D. A Clinician’s Guide to Tuberculosis. Philadelphia: Lippincott Williams & Wilkins.2000
World Health Organization, 2016. Global Tuberculosis Report 2016
Maurya VK, Sharma P, Ravikumar R, Debnath J, Sharma V, Srikumar S, Bhatia M. Tubercular spondylitis: A review of MRI findings in 80 cases. Med J Armed Forces India. 2018 Jan;74(1):11-17. doi: 10.1016/j.mjafi.2016.10.011. Epub 2016 Nov 30. PMID: 29386725; PMCID: PMC5771763.
Singh R, Magu NK, Rohilla RK. Clinicoradiologic Profile of Involvement and Healing in Tuberculosis of the Spine. Ann Med Health Sci Res. 2016 Sep-Oct;6(5):311-327. doi: 10.4103/amhsr.amhsr_188_15. PMID: 28503350; PMCID: PMC5414445.
Kusmiati T, Narendrani HP. Potts disease. Jurnal Respirasi Vol 2 No 3. Departemen Pulmonologi dan Ilmu Kedokteran Respirasi, Fakultas Kedokteran, Universitas Airlangga. 2016
Garg B, Mehta N, Mukherjee RN, Swamy AM, Siamwala BS, Malik G. Epidemiological Insights from 1,652 Patients with Spinal Tuberculosis Managed at a Single Center: A Retrospective Review of 5-Year Data. Asian Spine J. 2022 Apr;16(2):162-172. doi: 10.31616/asj.2021.0137. Epub 2021 Sep 1. PMID: 34461687; PMCID: PMC9066256.
Wang P, Liao W, Cao G, Jiang Y, Rao J, Yang Y. Characteristics and Management of Spinal Tuberculosis in Tuberculosis Endemic Area of Guizhou Province: A Retrospective Study of 597 Patients in a Teaching Hospital. Biomed Res Int. 2020 Jan 30;2020:1468457. doi: 10.1155/2020/1468457. PMID: 32071918; PMCID: PMC7011346.
Park JH, Shin HS, Park JT, Kim TY, Eom KS. Differentiation between Tuberculous Spondylitis and Pyogenic Spondylitis on MR Imaging. Korean J Spine. 2011 Dec;8(4):283-7. doi: 10.14245/kjs.2011.8.4.283. Epub 2011 Dec 31. PMID: 26064146; PMCID: PMC4461740.
Ansari S, Amanullah MF, Ahmad K, Rauniyar RK. Pott's Spine: Diagnostic Imaging Modalities and Technology Advancements. N Am J Med Sci. 2013 Jul;5(7):404-11. doi: 10.4103/1947-2714.115775. PMID: 24020048; PMCID: PMC3759066.
Yasin P, Mardan M, Xu T, Cai X, Abulizi Y, Wang T, Sheng W, Mamat M. Development and validation of a diagnostic model for differentiating tuberculous spondylitis from brucellar spondylitis using machine learning: A retrospective cohort study. Front Surg. 2023 Jan 6;9:955761. doi: 10.3389/fsurg.2022.955761. PMID: 36684365; PMCID: PMC9852539.
Danchaivijitr N, Temram S, Thepmongkhol K, Chiewvit P. Diagnostic accuracy of MR imaging in tuberculous spondylitis. J Med Assoc Thai. 2007;90(8):1581-1589.
Kubihal V, Sharma R, Krishna Kumar RG, Chandrashekhara SH, Garg R. Imaging update in spinal tuberculosis. J Clin Orthop Trauma. 2021 Dec 9;25:101742. doi: 10.1016/j.jcot.2021.101742. PMID: 34956831; PMCID: PMC8671643.
