Contrast medium-enhanced MRI findings and changes over time in stage I tuberculous meningitis

Öztoprak, İbrahim; Gümüş, Cesur; Öztoprak, Bilge; Engin, Aynur

doi:10.1016/j.crad.2007.06.001

Cited by 13 publications

(5 citation statements)

References 22 publications

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“…The imaging manifestations of CNS tuberculosis are very pleomorphic and can mimic parenchymal cerebral mass lesions or meningeal processes of a different nature [16]. Gadolinium-enhanced, T1-weighted imaging is the standard MRI technique used for evaluating meningeal disease and is routinely used in most centers [17]. The role of FDG PET or PET/CT in TBM was not fully elucidated [18].…”

Section: Discussionmentioning

confidence: 99%

Experience of Dual Time Point Brain F-18 FDG PET/CT Imaging in Patients with Infectious Disease

Kim

Park

et al. 2010

Nucl Med Mol Imaging

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Dual time point FDG PET imaging (DTPI) has been considered helpful for discrimination of benign and malignant disease, and staging lymph node status in patients with pulmonary malignancy. However, DTPI for benign disease has been rarely reported, and it may show a better description of metabolic status and extent of benign infectious disease than early imaging only. The authors report on the use F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) imaging with additional delayed imaging on a 52-year-old man with sparganosis and a 70-year-old man with tuberculous meningitis. To the best of our knowledge, this is the first report on dual time point PET/CT imaging in patients with cerebral sparganosis and tuberculous meningitis.

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Section: Discussionmentioning

confidence: 99%

Experience of Dual Time Point Brain F-18 FDG PET/CT Imaging in Patients with Infectious Disease

Kim

Park

et al. 2010

Nucl Med Mol Imaging

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“…23,84 South African investigators reported that the combination of hydrocephalus, basal enhancement and infarction was 100% specific and 41% sensitive for the diagnosis of childhood TBM, although the authors suggested pre-contrast hyperdensity in the basal cisterns was the best predictor of TBM. 85 Magnetic resonance imaging (MRI) provides high definition of infra-tentorial lesions and the early cerebral changes of TBM, 86,87 but data regarding the diagnostic sensitivity and specificity of these features are limited. Cryptococcal meningitis, cytomegalovirus encephalitis, toxoplasmosis, sarcoidosis, meningeal metastases, and lymphoma may all produce similar radiographic findings.…”

Section: What Is the Role Of Imaging Investigations?mentioning

confidence: 99%

British Infection Society guidelines for the diagnosis and treatment of tuberculosis of the central nervous system in adults and children

Thwaites

Fisher

Hemingway

et al. 2009

Journal of Infection

472

461

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“…On magnetic resonance imaging focal meningeal enhancement is much more frequently encountered than diffuse meningeal enhancement. Basal pial areas, particularly the interpeduncular fossa, were noted as the most preferred site of focal meningeal enhancement (78) (Fig. 2).…”

Section: Diagnosismentioning

confidence: 99%

Tuberculous meningitis

Garg

2009

Acta Neurologica Scandinavica

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Tuberculous meningitis is a severe form of extrapulmonary tuberculosis. The exact incidence and prevalence are not known. In countries with high burden of pulmonary tuberculosis, the incidence is expected to be proportionately high. Children are much more vulnerable. Human immunodeficiency virus-infected patients have a high incidence of tuberculous meningitis. The hallmark pathological processes are meningeal inflammation, basal exudates, vasculitis and hydrocephalus. Headache, vomiting, meningeal signs, focal deficits, vision loss, cranial nerve palsies and raised intracranial pressure are dominant clinical features. Diagnosis is based on the characteristic clinical picture, neuroimaging abnormalities and cerebrospinal fluid changes (increased protein, low glucose and mononuclear cell pleocytosis). Cerebrospinal fluid smear examination, mycobacterial culture or polymerase chain reaction is mandatory for bacteriological confirmation. The mortality and morbidity of tuberculous meningitis are exceptionally high. Prompt diagnosis and early treatment are crucial. Decision to start antituberculous treatment is often empirical. WHO guidelines recommend a 6 months course of antituberculous treatment; however, other guidelines recommend a prolonged treatment extended to 9 or 12 months. Corticosteroids reduce the number of deaths. Resistance to antituberculous drugs is associated with a high mortality. Patients with hydrocephalus may need ventriculo-peritoneal shunting. Bacillus Calmette-Guérin vaccination protects to some degree against tuberculous meningitis in children.

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Contrast medium-enhanced MRI findings and changes over time in stage I tuberculous meningitis

Cited by 13 publications

References 22 publications

Experience of Dual Time Point Brain F-18 FDG PET/CT Imaging in Patients with Infectious Disease

Experience of Dual Time Point Brain F-18 FDG PET/CT Imaging in Patients with Infectious Disease

British Infection Society guidelines for the diagnosis and treatment of tuberculosis of the central nervous system in adults and children

Tuberculous meningitis

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