Evaluation of intracranial tuberculomas using diffusion-weighted imaging (DWI), magnetic resonance spectroscopy (MRS) and susceptibility weighted imaging (SWI)

Abstract

The results from the present study suggest promising role of SWI in the discrimination of tuberculomas from metastatic brain lesions and gliomas with the presence of a complete and regular peripheral hypointense ring favoring the diagnosis of tuberculomas.

Central nervous system and spinal cord tuberculosis: Revisiting an important disease

“…The main finding on SWI sequences of tuberculomas are a profound and complete hypointense ring signal of the capsule, which contain paramagnetic ions [27]. Metastatic lesions and gliomas, lesions with similar morphologic features did not show a complete peripheral hypointense ring [27].…”

“…MRI Spectroscopy (MRS) may be useful in atypical presentations of tuberculoma, and MRI venography and angiography may be useful in vascular complications [26]. Recently, Susceptibility Weighted Imaging (SWI) sequences were proved useful in the diagnosis of tuberculomas and its discrimination from metastatic brain lesions and gliomas [27].…”

“…CT can be helpful in the emergency setting, especially in the beginning of the treatment in order to authorize the CNS puncture for analysis. Thin-sliced non-contrast CT (< 3 mm) may be useful in identifying hypodense lesions and opacification of basal cisterns, whereas contrast CT could be important in finding tuberculomas [27].…”

“…SWI, an image technique that is generated by the susceptibility differences between paramagnetic (mostly blood products) and diamagnetic materials, is useful for the characterization of tuberculomas. Due to its high sensibility to detect paramagnetic substances like blood, hemorrhage and iron deposition was proved useful to identify the hypointense signal on the capsule of a tuberculoma [27]. The main finding on SWI sequences of tuberculomas are a profound and complete hypointense ring signal of the capsule, which contain paramagnetic ions [27].…”

“…Due to its high sensibility to detect paramagnetic substances like blood, hemorrhage and iron deposition was proved useful to identify the hypointense signal on the capsule of a tuberculoma [27]. The main finding on SWI sequences of tuberculomas are a profound and complete hypointense ring signal of the capsule, which contain paramagnetic ions [27]. Metastatic lesions and gliomas, lesions with similar morphologic features did not show a complete peripheral hypointense ring [27].…”