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Intracranial Artery Injury in HIV-negative Tuberculous Meningitis

A High-Resolution Vessel Wall Imaging Study

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Abstract

Purpose

The features of intracranial arterial injury in tuberculous meningitis (TBM) are of important diagnostic and prognostic value. The study aimed to elucidate the high-resolution vessel wall imaging (HR-VWI) manifestations of intracranial arterial insults in TBM.

Methods

The clinical data, routine cranial magnetic resonance imaging, magnetic resonance angiography (MRA) and HR-VWI before and after contrast enhancement of intracranial arteries in clinically diagnosed TBM patients were retrospectively analyzed.

Results

In this study 27 TBM patients were included. Abnormalities in the intracranial arteries were detected in all patients using HR-VWI. Typical vessel insults included nodular or granular lesions, related thickness and prominent enhancement in the wall, and lumen narrowing or occlusion. The most frequently involved arteries were the C4 segment of the internal carotid artery and the P1 segment of the posterior cerebral artery. The lesions were consistent with disease stage and disease duration and correlated with infarction.

Conclusion

The use of HR-VWI revealed that cerebral artery involvement in patients with TBM is much more common and extensive than in previous radiological reports. The use of HR-VWI improves recognition of arterial pathologies and has diagnostic value in patients with TBM.

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Funding

This study was supported by the Medical Scientific Research Foundation of Guangdong Province, China (A2016224), the National Natural Science Foundation of China (81701172) and the Special Fund Project of Science and Technology in Guangdong Province (2017B020247038).

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Authors and Affiliations

  1. Department of Neurology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

    Tingting Lu, Yu Yang, Aimin Wu & Zhengqi Lu

  2. Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

    Yan Zou, Ting Jiang & Zhuang Kang

  3. Department of Neurology and Stroke Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

    Hongbing Chen

  4. State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China

    Xinqing Lin

  5. Guangzhou Chest Hospital, Guangzhou, China

    Yimin Fang

Authors
  1. Tingting Lu
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  2. Yan Zou
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  3. Ting Jiang
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  4. Yu Yang
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  5. Aimin Wu
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  6. Hongbing Chen
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  7. Zhuang Kang
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  8. Xinqing Lin
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  9. Yimin Fang
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  10. Zhengqi Lu
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Corresponding authors

Correspondence to Yimin Fang or Zhengqi Lu.

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Conflict of interest

T. Lu, Y. Zou, T. Jiang, Y. Yang, A. Wu, H. Chen, Z. Kang, X. Lin, Y. Fang and Z. Lu declare that they have no competing interests.

Additional information

T. Lu and Y. Zou contributed equally to this paper.

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Lu, T., Zou, Y., Jiang, T. et al. Intracranial Artery Injury in HIV-negative Tuberculous Meningitis. Clin Neuroradiol 30, 381–388 (2020). https://doi.org/10.1007/s00062-019-00766-4

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  • DOI: https://doi.org/10.1007/s00062-019-00766-4

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