Comparative Analysis of Computed Tomography and Magnetic Resonance Imaging in the Evaluation of Congenital Thoracic Scoliosis
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Abstract
Background: Congenital thoracic scoliosis is a structural spinal deformity caused by abnormal vertebral development and may be associated with occult neural axis abnormalities. Computed tomography provides detailed assessment of osseous malformations, whereas magnetic resonance imaging enables evaluation of the spinal cord and associated intraspinal abnormalities. Objective: To comparatively analyze CT and MRI findings in patients with congenital thoracic scoliosis and determine whether specific CT-detected vertebral anomalies are associated with MRI-detected neural axis abnormalities. Methods: A cross-sectional comparative imaging study was conducted at Ghurki Trust and Teaching Hospital, Lahore, over six months. Seventy-seven patients aged 11–19 years with congenital thoracic scoliosis who underwent both CT and MRI were included. CT findings included block vertebra, hemivertebra, vertebral anomalies, rib anomalies, and vertebral wedging/rotation, while MRI findings included tethered cord, diastematomyelia, and other neural axis abnormalities. Data were analyzed using SPSS version 25.0, with chi-square test, Fisher’s exact test, t-test, ANOVA, odds ratios, and logistic regression applied where appropriate. Results: Tethered cord was detected in 19 patients (24.7%) and diastematomyelia in 24 patients (31.2%). Block vertebra showed a significant association with tethered cord (χ² = 5.229, p = 0.022) and was an independent predictor of MRI-detected abnormality (adjusted OR = 5.344, 95% CI: 2.420–11.679; p < 0.001). Hemivertebra demonstrated a higher mean MRI anomaly burden than block vertebra in focused comparison (6.43 vs 4.39; p = 0.002), while overall differences across broader CT groups were not significant (p = 0.126). Conclusion: CT and MRI are complementary in evaluating congenital thoracic scoliosis. Block vertebra is a clinically important CT marker associated with MRI-detected tethered cord, supporting integrated imaging assessment for accurate diagnosis, neural risk detection, and preoperative planning.
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