To evaluate the value of gadolinium(Gd)-enhancement in the examination of spinal tuberculosis using magnetic resonance(MR) imaging in 25 surgically-confirmed cases of spinal tuberculosis, we studied(1) the ability of MR to show the extent of the lesions among Gd-enhanced T1 weighted images and non-contrast T1, proton density, and T2 weighted images, and (2) the specific contrast enhancing patterns of the lesions. The Gd-enhanced T1-weighted images were better in evaluating the extent of the disease than the noncontrast T1, T2, and proton density images in 68%, 52%, and 68%, respectively. After Gd-DTPA enhancement, the inflammatory tissues showed 2 types of rim enhancement: (1) irregular thick enhancing wall with central low intensity and (2) uniformly thin rim enhancement in large mass suggesting cold abscess. We concluded that Gd enhancement was valuable in MR examination of spinal tuberculosis in evaluating the disease extent as well as specific diagnosis by characteristic rim enhancement.