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Neuroradiology

, Volume 32, Issue 1, pp 19–25 | Cite as

Gd-DTPA enhanced MR imaging in intracranial tuberculosis

  • K. -H. Chang
  • M. -H. Han
  • J. -K. Roh
  • I. -O. Kim
  • M. -C. Han
  • K. -S. Choi
  • C. -W. Kim
Originals

Summary

Twenty-six patients with intracranial tuberculosis (Tb) (10 with acute meningitis, 5 with chronic meningitis, 5 with meningitic sequelae and 6 with localized tuberculoma(s) were examined with MR before and after Gd-DTPA enhancement (0.1 mmol/kg), using 2.0T superconducting unit, and the images were retrospectively analyzed and compared with CT scans. Without Gd-DTPA enhancement, the MR images were generally insensitive to detection of active meningeal inflammation and granulomas. The signal intensity of granulomas was usually isointense to gray matter on both T1- and T2-weighted images, whether they were associated with diffuse meningitis or presented as localized tuberculoma(s). A few granulomas showed focal hypointensity on T2-weighted images. Calcifications seen on CT of the meningitic sequelae group usually appeared markedly hypointense on all spin-echo sequences. On Gd-DTPA enhanced T1-weighted images, abnormal meningeal enhancement indicating active inflammation was conspicuous, and the granulomas often appeared as conglomerated ring-enhancing nodules, which seems to be characteristic of granulomas. Thin rim enhancement around the suprasellar calcifications were observed in two out of 5 patients with meningitic sequelae. Compared with CT, MR detected a few more ischemic infarcts, hemorrhagic infarcts, meningeal enhancement and granulomas in the acute meningitis group, but missed small calcifications in the basal cisterns well shown on CT in the sequelae group. Otherwise, MR generally matched CT scans. MR imaging appears to be superior to CT in evaluation of active intracranial Tb only if Gd-DTPA is used, while CT is better than MR in evaluating meningitic sequelae with calcification.

Key words

Magnetic resonance imaging Tuberculosis 

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References

  1. 1.
    Sheller JR, DesPrez RM (1986) CNS tuberculosis. Neurol Clin 4:143–158Google Scholar
  2. 2.
    Price HI, Danziger A (1978) Computed tomography in cranial tuberculosis. AJR 130:769–771Google Scholar
  3. 3.
    Bhargava S, Gupta AK, Tandon PN (1982) Tuberculous meningitis; a CT study. Br J Radiol 55:189–196Google Scholar
  4. 4.
    Rovira M, Romero F, Torrent O, Ibarra B (1980) Study of tuberculous meningitis by CT. Neuroradiology 19:137–141Google Scholar
  5. 5.
    Casselman ES, Hasso AN, Ashwal S, Schneider S (1980) Computed tomography of tuberculous meningitis in infants and children. J Comput Assist Tomogr 4:211–216Google Scholar
  6. 6.
    Whelan MA, Stern J (1981) Intracranial tuberculoma. Radiology 138:75–81Google Scholar
  7. 7.
    Bhargava S, Tandon PN (1980) Intracranial tuberculomas; a CT study. Br J Radiol 53:935–945Google Scholar
  8. 8.
    Zimmerman RA, Bilaniuk LT, Sze G (1987) Intracranial infection. In: Brant-Zawadzki M, Norman D (eds) Magnetic resonance imaging of central nervous system. Raven, New York, pp 235–257Google Scholar
  9. 9.
    Sze G (1988) Infections and inflammatory diseases. In: Stark DD, Bradley WG (eds) Magnetic resonance imaging. Mosby, St Louis, pp 316–343Google Scholar
  10. 10.
    Davidson HD, Steiner RE (1985) Magnetic resonance imaging in infections of the central nervous system. AJNR 6:499–504Google Scholar
  11. 11.
    Schroth G, Kretzschmar K, Gawehn J, Voigt K (1987) Advantage of magnetic resonance imaging in the diagnosis of cerebral infections. Neuroradiology 29:120–126Google Scholar
  12. 12.
    Sze G, Zimmerman RD (1988) Magnetic resonance imaging of infections and inflammatory diseases. Radiol Clin North Am 26:839–859Google Scholar
  13. 13.
    Zimmerman RD, Becker RD, Devinsky O, et al. (1986) Magnetic resonance imaging features of cerebral abscesses and other intracranial inflammatory lesions. Acta Radiol [Suppl] 369:754Google Scholar
  14. 14.
    Gupta RK, Jena A, Sharma A, et al. (1988) MR imaging of intracranial tuberculomas. J Comput Assist Tomogr 12:280–285Google Scholar

Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • K. -H. Chang
    • 1
  • M. -H. Han
    • 1
  • J. -K. Roh
    • 2
  • I. -O. Kim
    • 1
  • M. -C. Han
    • 1
  • K. -S. Choi
    • 3
  • C. -W. Kim
    • 1
  1. 1.Department of Diagnostic Radiology, College of MedicineSeoul National UniversitySeoulKorea
  2. 2.Department of Neurology, College of MedicineSeoul National UniversitySeoulKorea
  3. 3.Department of Neurosurgery, College of MedicineSeoul National UniversitySeoulKorea

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