Estimation of role of CT scan and MRI in diagnosis of tuberculosis of brain and spine.

Background: Tuberculosis of the brain and spine is a very severe disease and causes increased rate of mortality and morbidity. Its diagnosis is a challenge for physicians worldwide. Patients of different age groups and having varied socio-economic status suffer from neurotuberculosis which need to be evaluated successfully to help the physician with further management of the condition. Aim: To estimate role of CT scan and MRI in diagnosis of tuberculosis of brain and spine. Material and methods: Patients referred to the Radiology Department with any kind of neurological symptoms, coincidental finding of neurotuberculosis or even those with already diagnosed cases of neurotuberculosis which needed follow up radiological investigations were evaluated with either CT or MRI or sometimes both (These were performed on 1.5 T Philips MRI and Seimens 16 Slice MDCT machine). Results: Patients with intracranial tuberculosis mainly presented with tuberculous meningitis and tuberculomas. Most patients suffering from spinal infection presented with Pott’s spine. Most of the lesions were paradiscal with involvement of the articular discs. MRI is more sensitive than CT scan in the diagnosis of intracranial tuberculosis. MRI is also very sensitive in the diagnosis of intracranial. tuberculosis as compared to CT. CT had no significant role in the diagnosis of Spinal tuberculosis. Hence, MRI is the preferred choice of investigation while evaluating neurotuberculosis.

Analysis on clinical and CT imageological features in 276 cases of intracranial tuberculosis / 重庆医学

Objective To investigate the clinical and head CT imageological features features in 276 cases of intracranial tubercu‐losis .Methods The clinical and CT features in 276 inpatients with confirmed intracranial tuberculosis were analyzed .Results These 276 cases of intracranial tuberculosis all were complicated by pulmonary tuberculosis ,among them blood‐borne type accoun‐ted for 49 .6% ; young and middle‐aged cases were predominant (72 .5% ) ; the majority manifested by the symptoms of fever (70 .0% ) and headache(66 .2% ) ;the summer and autumn had the higher incidence rate ,which were 167 cases(80 .7% ) .The posi‐tive detection rate of head CT plain scanning was 63 .4% ,which of enhanced scanning was 98 .6% .Among them ,236(85 .5% ) cases were tuberculous meningitis lesions ,158 cases(57 .2% ) were tuberculous encephalitis ,144 cases (52 .2% ) were tuberculoma and 133 cases (48 .2% ) were tuberculous vasculitis .Conclusion The clinical menifestations of intracranial tuberculosis are atypical ,but the head CT plain scannig displays multiple abnormalities .Moreover ,the enhanced scanning increases the positive detection rate . The lesions of meninges ,brain vessels and brain parenchyma often occur together .Therefore ,the diagnosis basis should be combined with clinic ,laboratory tests and head CT ,especially the clinical application of head CT enhanced scanning should be paid attention to .