Tuberculoma Versus Neurocysticercosis: Can Magnetic Resonance Spectroscopy and Diffusion Weighted Imaging Solve the Diagnostic Conundrum?

Maheshwarappa, Ravishankar Pillenahalli; Agrawal, Chandan; Bansal, Juhi

doi:10.7860/jcdr/2019/41334.12957

Cited by 7 publications

(12 citation statements)

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“…2b) and tuberculoma (Fig. 2a) were the most common infective lesions in our study, which is in coherence with a study done by Maheshwarappa RP et al 12 and Chander R et al 1 . In adults, most cases of neurocysticercosis were of stage IV disease, as also found by Chander R et al 1 Manjunath MN et al 13 in their study on CNS tuberculosis found predilection for younger population in 60-70% of cases.…”

Section: Infective Lesionssupporting

confidence: 93%

Role of Computed Tomography in the Evaluation of Intracranial Posterior Fossa Lesions

2020

IJPHRD

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Background :The prime imaging modality available for imaging the posterior fossa are CT and MRI. CT is non-invasive, provides 3-D cross sectional anatomy of brain, which can be reformatted in multiple planes. CT provides more detail about the nature of calcification.The posterior fossa lesions can be broadly classified into 1) Mass lesions 2) Inflammatory lesions 3) Traumatic lesions 4) Vascular lesions 5) Congenital malformations. Objective is to evaluate the computed tomography features of various types of lesions in the posterior fossa, their appearances and to determine the age and sex distribution. Materials and Methods:This was a prospective study carried out on 60 patients, age range was 0-80 years, who were referred to the Department of Radio-Diagnosis for CT at Rohilkhand Medical College and Hospital for a period of one year from November 2018 to October 2019 using 16 slice GE Brightspeed Elite third generation CT machine. Results & Conclusion:CT was highly accurate and efficient in diagnosing various posterior fossa lesions. It has an upper hand over MRI in characterization of bony changes and calcification.

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Section: Infective Lesionssupporting

confidence: 93%

Role of Computed Tomography in the Evaluation of Intracranial Posterior Fossa Lesions

2020

IJPHRD

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“…Signs and symptoms, such as fever and a raised erythrocyte sedimentation rate, may also be present to suggest an inflammatory lesion, although they are not specific or confirmatory. Therefore, MRS would increase the possibility of a correct diagnosis as it can provide additional biochemical information and diffusion imaging that is based on the restriction of water molecules by the lesion [12].…”

Section: Discussionmentioning

confidence: 99%

Intracranial Tuberculoma in a Pregnant Lady: A Hitherto Unknown Case and a Successful Outcome

Vempati¹,

Samuganathan²,

Raghavan³

et al. 2022

Cureus

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Central nervous system tuberculosis (CNS-TB) is rarely suspected in pregnancy because its clinical presentation may masquerade other common conditions in pregnancy, such as eclampsia. In high tuberculosis endemic areas, CNS-TB should be suspected with a high degree of suspicion among unimmunized and immunocompromised individuals. We hereby report a case of a 32-year-old pregnant woman conceived by in vitro fertilization due to tubal blockage causing infertility, probably due to chronic infection, who presented with a history of multiple seizure episodes without a history of similar complaints outside this pregnancy. Obstetric examination revealed a gravid uterus larger than the corresponding gestational age, and an antenatal scan confirmed dichorionic diamniotic twins with the first twin in the breech and the second twin in the cephalic presentation. Magnetic resonance imaging of the brain revealed multiple nodular lesions of varying sizes that were isointense on T1-weighted imaging and hypointense on T2-weighted imaging in multiple regions of the brain, which suggest tuberculomas. A preterm cesarean section was performed at 31 weeks gestational age due to preterm rupture of membranes. We report this case to enlighten the physicians in diagnosing seizures causing intracranial tuberculoma in pregnant women and utilizing the role of imaging in diagnosis.

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“…22 Recent advances in conventional imaging including sequences such as perfusion weighted imaging, diffusion weighted imaging and MR spectroscopy have significantly improved the diagnosis of intracranial tuberculomas and its differentiation from closely mimicking pathologies, however to the best of our knowledge no clinical or imaging method exists, which at source can determine the treatment response in intracranial tuberculomas. 23,24 In our cohort also we observed that conventional MRI imaging cannot reliably differentiate the two types of responses. Therefore, development of an image-based tool which at source can predict the eventual outcome of disease and separate responsive versus resistant cases can be extremely helpful, which can allow making a wise choice between various medical and surgical treatment options, determination of the treatment outcome and early counseling of patient regarding approximate expectation.…”

Section: Discussionmentioning

confidence: 59%

MR textural features (RADIOMICS) for predicting response to treatment in patients with intracranial tuberculoma: A retrospective cross-sectional study

Awais¹,

Khan²,

Muhammad³

et al. 2023

PJNS

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Background and objective: MR based radiomics can potentially response to treatment in intracranial tuberculoma, but very scarce literature is available in this regard. The purpose of this study was to determine whether MR based radiomic features can be used to predict response to antituberculosis (AT) treatment. Methods: Data of patients with intracranial tuberculomas who underwent MR imaging and AT treatment at our institution during the last 10 years was analyzed. In each case follow-up imaging performed at 6 months post initiation of treatment was reviewed to establish response to treatment. The textural analysis was performed by two consultant neuroradiologists, using open-source software (Lifex) with FLAIR coronal image after contrast administration from pretreatment MRI study radiomic analysis. Results: Twenty-four patients with mean age 33.8 years were included in the study. Sixteen patients were in the treatment responsive group while eight patients were in the treatment resistant group. Thirty-eight radiomic parameters were extracted for each patient. There was a significant difference in three out of 38 parameters (histogram skewness, GLCM correlation and NGLDM Coarseness) in patients amongst the two groups. Logistic regression model was developed using these parameters which accurately predicted 83.3% of the cases according to the response to the AT treatment (χ2=11.517, p=0.003). ROC curve analysis was performed using histogram skewness which showed acceptable discrimination (p=0.037 and 95% CI =0.577-0.954) for predicting the response to treatment. Conclusion: MR textural parameters (histogram skewness, GLCM correlation and NGLDM Coarseness) may be used as imaging biomarkers to predict response to treatment in patients with intracranial tuberculoma.

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Tuberculoma Versus Neurocysticercosis: Can Magnetic Resonance Spectroscopy and Diffusion Weighted Imaging Solve the Diagnostic Conundrum?

Cited by 7 publications

References 0 publications

Role of Computed Tomography in the Evaluation of Intracranial Posterior Fossa Lesions

Role of Computed Tomography in the Evaluation of Intracranial Posterior Fossa Lesions

Intracranial Tuberculoma in a Pregnant Lady: A Hitherto Unknown Case and a Successful Outcome

MR textural features (RADIOMICS) for predicting response to treatment in patients with intracranial tuberculoma: A retrospective cross-sectional study

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