Differentiation of tubercular infection and metastasis presenting as ring enhancing lesion by diffusion and perfusion magnetic resonance imaging

Chatterjee, Subhajit; Saini, Jitender; Kesavadas, Chandrasekharan; Arvinda, H R; Jolappara, M.; Gupta, Arun Kumar

doi:10.1016/j.neurad.2009.08.005

Cited by 30 publications

(28 citation statements)

References 21 publications

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“…The usual manifestations include acute and chronic meningitis, granulomata, encephalopathy and abscess. Tuberculoma is the focal granulomatous form, encountered in about 10%-40% of CNS tuberculosis [10]. Histologically, the mature tuberculomas are composed of necrotic caseous center surrounded by a capsule that contains fibroblasts, epitheloid cells, Langhans cells and lymphocytes formed by coalescence of microtuberculomas.…”

Section: Discussionmentioning

confidence: 99%

“…There are only a few pathophysiological studies in CNS tuberculosis using SPECT and MR perfusion imaging techniques [8][9][10]22].…”

Section: Discussionmentioning

confidence: 99%

“…However, the lesions were presumed to be of tubercular aetiology in lieu of histological verification of the lesions [8]. Recent MR perfusion studies are promising in differentiating intracranial ring enhancing tuberculomas from ring enhancing metastases [9,10].…”

Section: Introductionmentioning

confidence: 99%

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CT Perfusion Dynamics of Intracranial Tuberculomas

Shivashankar³

2015

JCDR

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Section: Discussionmentioning

confidence: 99%

“…There are only a few pathophysiological studies in CNS tuberculosis using SPECT and MR perfusion imaging techniques [8][9][10]22].…”

Section: Discussionmentioning

confidence: 99%

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CT Perfusion Dynamics of Intracranial Tuberculomas

Shivashankar³

2015

JCDR

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“…The mean rCBV ratio of periphery of mass and normal reference white matter is around one in cases of tuberculoma while mean rCBV ratio is more than five in case of metastasis. [3] MR-spectroscopy usually reveals a large lipid lactate peak at 0.9 to 1.33 ppm and reduced NAA. The lipid peak in tuberculoma is primarily due to the predominant lipid content in the cell wall of tubercle bacillus.…”

Section: Magnetic Resonance Perfusion and Spectroscopy In A Giant Tubmentioning

confidence: 99%

Magnetic resonance perfusion and spectroscopy in a giant tuberculoma

Naphade¹,

Raut²,

Pai³

2011

Neurol India

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References 1. Voltz R. Paraneoplastic neurological syndromes: an update on diagnosis, pathogenesis, and therapy. Lancet Neurol 2002; 1:294-305. 2. Baloh RW, DeRossett SE, Cloughesy TF, Kuncl RW, Miller NR, Merrill J, et al. Novel brainstem syndrome associated with prostate carcinoma. Neurology 1993; 43:2591-6. 3. Berger JR, Bensalem M, Dalmau J. A brainstem paraneoplastic syndrome associated with prostate cancer. J Neurol Neurosurg Psychiatry 2009; 80:934-5. 4. Schüller M, Jenne D, Voltz R. The human PNMA family: Novel neuronal proteins implicated in paraneoplastic neurological disease. J Neuroimmunol 2005; 169:172-6. 5. Dalmau J, Graus F, Villarejo A, Posner JB, Blumenthal D, Thiessen B. Clinical analysis of anti-Ma2-associated encephalitis. Brain 2004; 127:1831-44. 6. Gultekin SH, Rosenfeld MR, Voltz R, Eichen J, Posner JB, Dalmau J. Paraneoplastic limbic encephalitis: Neurological symptoms, immunological findings and tumour association in 50 patients. Brain 2000; 123:1481-94. 7. Sutton I, Winer J, Rowlands D, Dalmau J. Limbic encephalitis and antibodies to Ma2: A paraneoplastic presentation of breast cancer.

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“…Similarly, only one small preliminary study has been published comparing the perfusion characteristics of tuberculomas and metastases (4). If the perfusion patterns of tuberculomas are well understood, perfusion studies may help increase the degree of confidence of their diagnosis on MRI.…”

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confidence: 99%