Learning objectives
To describe the range of radiological findings in atypical cases of CNS tuberculosis with special attention to its complications and sequelae that allow for early, accurate diagnosis and disease monitoring.In this poster we will review the importance of of magnetic resonance imaging (MRI) offering greater inherent sensitivity and specificity than CT scan, which help in early diagnosis and diffrentiation from mimics. In addition to conventional MRI imaging, diffusion imaging, and proton magnetic resonance spectroscopy techniques are complementary and equally important for better tissue characterization in...
Background
CNS tuberculosis leads to significant neurological disability, complications, sequelae and mortality in developing countries. Its incidence has risen in tandem with the spread of HIV/AIDS. Clinicians depend upon neuroradiologist to provide accurate diagnosis and direct therapy.Tuberculosis (TB), caused byMycobacterium tuberculosis,accounts for eight million annual, worldwide deaths. Involvement of the central nervous system (CNS) is one of the most serious forms of this infection .Granulomatous inflammatory reaction in CNS caused byM. tuberculosismay involve the meninges, brain, spinal cord, and the bones covering the brain and spinal...
Imaging findings OR Procedure details
The Atypical imaging presentation of CNS tuberculosis includes:Gaint tuberculomas mimicking the high grade gliomaPitutary tuberculomaInflammatory endarteritis obliterens due to involvment of arteries which course through exudates causing spasm and intimal changes resulting in thrombosis and infarction. Infarctions are more common in children and most commonly involve perforating branches supplying the basal ganglia. Arteritis causing Moya Moya patternExtraaxial tuberculoma mimicking meningiomaAlthough both CT and MRI can demonstrate these findings but MRI detects it much earlier. Similarly, in atypical imaging presentation advance MR imaging such as diffusion...
Conclusion
MRI is accurate in diagnosing the atypical manifestations of CNS tuberculosis, especially with the help of perfusion and MR spectroscopy.In atypical presentation of CNS tuberculosis knowledge of MR imaging features in appropriate clinical context leads to early diagnosis and early management decreasing the neurological disability associated with it.
Personal Information
M.D. Agrawal, P.S. Naphade, S.S. Sankhe, K.M. Siva;Department of Radiology,KEM Hospital,Mumbai-400012,Maharashtra,India.Email-
[email protected]
References
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