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Intracranial Artery Injury in HIV-negative Tuberculous Meningitis

A High-Resolution Vessel Wall Imaging Study
  • Tingting Lu
  • Yan Zou
  • Ting Jiang
  • Yu Yang
  • Aimin Wu
  • Hongbing Chen
  • Zhuang Kang
  • Xinqing Lin
  • Yimin FangEmail author
  • Zhengqi LuEmail author
Original Article
  • 36 Downloads

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.

Keywords

Magnetic resonance angiography Internal carotid artery Middle cerebral artery High-resolution vessel wall imaging Tuberculous meningitis 

Notes

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).

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.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Tingting Lu
    • 1
  • Yan Zou
    • 2
  • Ting Jiang
    • 2
  • Yu Yang
    • 1
  • Aimin Wu
    • 1
  • Hongbing Chen
    • 3
  • Zhuang Kang
    • 2
  • Xinqing Lin
    • 4
  • Yimin Fang
    • 5
    Email author
  • Zhengqi Lu
    • 1
    Email author
  1. 1.Department of Neurology, The Third Affiliated HospitalSun Yat-sen UniversityGuangzhouChina
  2. 2.Department of Radiology, The Third Affiliated HospitalSun Yat-sen UniversityGuangzhouChina
  3. 3.Department of Neurology and Stroke Center, The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina
  4. 4.State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated HospitalGuangzhou Medical UniversityGuangzhouChina
  5. 5.Guangzhou Chest HospitalGuangzhouChina

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