MRI to demonstrate diagnostic features and complications of TBM not seen with CT

Date
2009
Authors
Pienaar M.
Andronikou S.
Van Toorn R.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Background: Computed tomography (CT) findings in children with tuberculous meningitis (TBM) often do not explain the clinical presentation and may even be normal. Magnetic resonance imaging (MRI) has the potential to diagnose TBM with greater sensitivity than CT and also to detect more infarcts. Aim: The aim of this study was to determine whether MRI demonstrates features and complications of TBM not present on CT. Materials and methods: Retrospective, blinded evaluation and comparison of CT and MRI findings in children with TBM were performed. Results: Of 30 children included, MRI demonstrated eight more with basal enhancement and four more with infarctions. Overall, MRI demonstrated an additional 104 sites of infarction (of a total 172) than CT. Of these, 89 were acute and visualized only on diffusion-weighted image. MRI showed five more patients with unilateral and two more with bilateral basal ganglia infarcts than CT as well as 19 brainstem infarcts. Hydrocephalus was equally detected by MRI and CT. Conclusion: MRI is superior to CT for diagnosing TBM (by detecting basal enhancement in more patients) and prognosis (by detecting many more infarcts in strategic locations). The role of CT is defined for the acute setting in detecting hydrocephalus for surgical management. © 2008 Springer-Verlag.
Description
Keywords
adolescent, article, basal ganglia infarction, bilateral thalami infarction, brain infarction, brain stem infarction, cerebellum infarction, child, clinical article, computer assisted tomography, corpus callosum infarction, diffusion weighted imaging, extrapyramidal syndrome, female, human, hydrocephalus, infant, male, nuclear magnetic resonance imaging, preschool child, priority journal, school child, thalamic infarction, tuberculous meningitis, Adolescent, Brain, Brain Infarction, Child, Child, Preschool, Female, Granuloma, Humans, Hydrocephalus, Infant, Magnetic Resonance Imaging, Male, Prognosis, Retrospective Studies, Tomography, X-Ray Computed, Tuberculosis, Meningeal
Citation
Child's Nervous System
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