 Hi, I'm Dr. Veena Vagharsath, third year radiology resident from Arachid Medical College in Hantabad. Today I'm presenting paper on role of MRI in evaluation of tuberculosis with its comparison with CT. Ames and Objectives, the role of MRI in evaluation of the tuberculosis of spine as an investigative modality in its document its value in early diagnosis. To identify sensitivity and specificity of MRI is compared to CT, studying the MRI appearance of TB, spine encountered in our hospital. Introduction, TB of spine is one of the most common infection of the spine in developing countries, the morbidity and mortality rate due to spinal TB is higher. Tuberculosis of spine is caused by mycobacterium tuberculosis. It affects the various part of the spine like vertebrae, intervertebral disc, perispinal soft tissue, epidural space and now roots. Usually two continuous vertebrae are involved but several vertebrae may be affected. Skiplies and solitary vertebral environment may also be seen. Various diagnostic investigations like CBC, ESR, Montuq, CELISA, PCR are done for diagnosing the TB. We can do culture, antibiotic sensitivity and histopath. CT and MRI frequently use imaging modalities in evaluating spinal infection. MRI provides more exact anatomic localization of vertebral and paravertebral lesion in multiple planes. It's extended on thica, cord and foramen when CT is useful to evaluate boundary destruction. Multiples and method, retrospectly study on 25 patients with tuberculosis of spine from June 2019 to March 2021. Diagnosis was established on the basis of at least one of the following criteria, histopath evidence of teseating granuloma, histopathic demonstration of acid parts best alive within the lesion. Growth of mycobacterium and culture of tissue, satisfactory therapeutic response to chemotherapy in patient with the clinical or radiological evidence of spine TB. CT and MRI spina was carried out in all the patient and features were compared. Inclusion criteria, 18 to 55 years of age of patient were included, patient presenting with chronic back pain who are not responding to conventional symptomatic management, deformity like angulation, deep births, permanent neurological deformities like ports, paraplegia. Old patients who have amazing features of TB spine on CT and MRI, patient of primary pulmonary or extra pulmonary tuberculosis with spinal involvement. Exclusion criteria, patient who have amazing feature of phytonyxpondylitis on CT and MRI, patient whose laboratory workup for cough came out to be negative. Here is a age and sex wise distribution. The study showed that majority of the patient were female as compared to male. Most common age group was 21 to 30 year followed by 31 to 40. Most common clinical feature is back pain followed by deformity with most patient being effibrillate during at the time of presentation. The paradiscule type of vertebral lesion is the most common followed by central anterior subligamentus and rarely in all the posterior elements. This study shows that the most common vertebrae involved is the dorsal followed by lumbar and cervical which sacral vertebrae being the least involved. This is a comparison between the MRI and CT findings of the various patient. The case of 19 year old female patient with lower back pain since three months MRI spine study show abnormal star hyperintensity involving sacrum on both sides. On left we have hyperindex collection on the left side of the sacrum. CT only lytic erosion is appreciated on left side of the sacrum. On MRI axial contrast imaging we can see that there is a involvement spread along the nerve roots. In T1 contrast suggested image there is a peripheral enhancing collection abscess noted in the pre sacral region extending in the epidural space which is not appreciated well on CT. This is another case of 25 year old female patient. I admitted for COVID-19 pneumonia. After few days she developed back pain and MRI was done abnormally to hyperintensity collection was noted along the right postulator aspect of the spine and the epidural collection extending into right perispinal region. The CT was normal and follow-up scan after three months of AKD significant improvement was noted. In star sagittal limit there is abnormal hyperintensity in safe patient at the D6 vertebral level which is not appreciated on CT. This is another 29 year old female patient with a complete of neck rigidity and pain. With contrast coronal images we can appreciate there is a collection in the right to perispinal region. The C1 and C2 vertebral levels CT coronal reconstructed bone window image shows light destruction of the right occipital condyle and C1 vertebrae on right side. On axial images there is a exact extent of the reason is better appreciated on MR. However bone erosion was better appreciated on CT. The coronal another patient coronal contrast C1 and C2 images we can see there is a collection in the left supraclavicular region which is extending into the spinal canal through the neural foramina. We can see here in star sagittal limit there is a granuloma which is also appreciated in the contrast CT. Exial T2 and T1 contrast and star sagittal CT contrast image is nodular thickening and clumping of the cordycephal and aurora with a diffuse enhancement and post-contrast study. Suggestive granulomatous erachnoditis. This is another patient, patient has a history of appendymoma and then after one year complaint of back pain we can see there is a anti-sublimentous collection and peravertebrate involvement. There is a destruction of the vertebrae we can appreciate it in CT. This give birth deformity. TB spondylitis is defined as infection by the mycobacterium tuberculosis involving one or more component of the spine namely the her vertebrae, the scopera, soft tissue and the epidural space. It mostly affect the young patient. Back pain was earliest and most common symptoms usually weak prior to the presentation. Most of the patients were effebrale at the presentation. Thoracic spine was the most common side of involvement followed by the number of spines. Spinal infection is usually the result of the hematogen is seeding in the vertebral body. The most common type of involvement was the paradiscal which occurs due to lateral spread where adjacent margin of two consecutive vertebrae are involved with the reduced disc space. The disc space narrowing is caused by the destruction of the subcontral bone with subsequent herniation of the disc into vertebral body or by direct involvement of the disc. On MR there is a T2 hyperintensity and post contrast enhancement seen in vertebral and blood and disc. Pre and paravertebral hepsis formations in many patients and sometimes it's prayed in epidural space and along now groups causing compression over the spinal cord and now groups resulting in a post paraplegia. Second most common type was the central type in which the infection spread along the buttocks and plexus of the vein. It involves the central portion of the single vertebrae. In anterior subliminal mental stack there is extension of hepsis beneath the anterior longitudinal ligament. It begins as a restrictive reason in the anterior margin of the vertebral body. It also extends into the epidural space and cause compression over the spinal cord. The least common type is the posterior type of involvement. It is spread via the posterior external venous plexus of the vertebral veins. Early changes in the bone marrow disc we can identify on T2 and start which is not pick up on CDS. This is progress in the destruction of the vertebral disc space, adjacent vertebrae, spinal animals, collabs and anti-abase leading to characteristic angulation and gimbals deformity. This is a fragmentary and light-exclerotic type of destruction of the vertebral element oper. It is important to differentiate in the spondylates from the pyazone. Pyazone's spondylates involve the disc where TB, spondylates usually has primary osteoscoinvolvement. Epsis in pyazone's spondylates is thick and irregular wall whereas in TB these are very different and thin walled. Pyazone's spondylates tend to occur does not involve more than two vertebral body. Whereas TB can involve multiple vertebral body which keep lesions. As in our study most of the patients where young female MRI is the best in mortality to avoid the radiation. MRI can very well delineate extent of lesion without contrast. However, in CT contrast study is required for better evaluation. Epidural spread and nerve root involvement is better evaluated on MRI in our study out of three patients. Nerv root involvement was detected on contrast study only in one patient. Conclusion, MRI is the best diagnostic modality and sensitive in CT as it better determines soft tissue extent, epidural extension, bone marrow involvement, effect on thica, cord and foramen and therefore its effect on neural structure as well as early changes of disease. Well CT is helpful mainly for assessing the bone structure. Thank you.