I K Indrajit1, S Ganesan1. 1. CIassified Specialist (Radiodiagnosis & Imaging), Department of Radiodiagnosis and Imaging, INHS Asvini, Colaba, Mumbai-400 005.
Abstract
UNLABELLED: Tuberculosis (TB) is still a major cause of serious illness in many parts of the world. Intracranially, TB manifests itself variably as meningitis, tuberculoma and tubercular abscess [1]. Although its appearance on MR is not absolutely specific, it is important in the proper clinical setting to recognize the range of possible patterns that can be observed on images [2]. Magnetic Resonance Imaging (MRI) has emerged as a quality imaging tool aiding in the diagnostic evaluation of intracranial TB variably displaying meningeal, parenchymal, osseous and craniovertebral lesions. The MRI characteristics of 18 cases of intracranial TB were reviewed. RESULTS: Multiple lesions occured with a slightly higher incidence at 61%. In all, 11 patients (61%) presented with meningitis. Meningeal lesions without parenchymal or vascular involvement were seen in 16% of cases. 2 patients had extension of enhancing exudates into the spinal subarachnoid spaces. While 6 patients had focal intra-axial tuberculomas, representing 33% cases, 3 patients presented with infarcts. 1 patient presented with haemorrhagic infarct at right middle cerebral artery territory while two other showed multiple small infarcts. Hydrocephalus was identified in 4 patients and epidural lesions were noted in 2 cases. MRI should be considered as the imaging modality of choice for patients with suspected intracranial TB.
UNLABELLED: Tuberculosis (TB) is still a major cause of serious illness in many parts of the world. Intracranially, TB manifests itself variably as meningitis, tuberculoma and tubercular abscess [1]. Although its appearance on MR is not absolutely specific, it is important in the proper clinical setting to recognize the range of possible patterns that can be observed on images [2]. Magnetic Resonance Imaging (MRI) has emerged as a quality imaging tool aiding in the diagnostic evaluation of intracranial TB variably displaying meningeal, parenchymal, osseous and craniovertebral lesions. The MRI characteristics of 18 cases of intracranial TB were reviewed. RESULTS: Multiple lesions occured with a slightly higher incidence at 61%. In all, 11 patients (61%) presented with meningitis. Meningeal lesions without parenchymal or vascular involvement were seen in 16% of cases. 2 patients had extension of enhancing exudates into the spinal subarachnoid spaces. While 6 patients had focal intra-axial tuberculomas, representing 33% cases, 3 patients presented with infarcts. 1 patient presented with haemorrhagic infarct at right middle cerebral artery territory while two other showed multiple small infarcts. Hydrocephalus was identified in 4 patients and epidural lesions were noted in 2 cases. MRI should be considered as the imaging modality of choice for patients with suspected intracranial TB.
Entities:
Keywords:
Intracranial tuberculosis; Magnetic resonance imaging; Tubercular meningitis
Authors: Sofiati Dian; Robby Hermawan; Arjan van Laarhoven; Sofia Immaculata; Tri Hanggono Achmad; Rovina Ruslami; Farhan Anwary; Ristaniah D Soetikno; Ahmad Rizal Ganiem; Reinout van Crevel Journal: PLoS One Date: 2020-11-13 Impact factor: 3.240