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Study of Intracranial Tuberculosis During Antituberculous Treatment Using Serial Dynamic MRI

Author: GuoLiFang
Tutor: ZhouXinHua
School: Beijing Tuberculosis and Thoracic Tumor Research Institute
Course: Internal Medicine
Keywords: Intracranial tuberculosis MRI DWI ADC values Dynamic MRI changes
CLC: R445.2
Type: Master's thesis
Year: 2011
Downloads: 36
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Abstract


Background and Purpose tuberculosis the body can affect almost all organs and tissues, approximately 6% of TB can invade the nervous system. Change occurs in the meninges or brain parenchyma tuberculosis diagnosis depends on more than the the CSF smear acid-fast staining and cerebrospinal fluid culture find acid-fast bacilli, but the culture process is relatively slow and the low rate of positive early clinical diagnosis of the disease can not be a good help. Magnetic resonance imaging (MRI) due to its advantages of great value in the diagnosis of intracranial tuberculosis. MRI imaging findings, this study aims to analyze intracranial tuberculosis in order to further an accurate understanding of the characteristics of intracranial tuberculosis images and its sub-type, and thus help to improve the level of MRI diagnosis of intracranial tuberculosis; by measuring brain parenchyma tuberculosis with lung cancer brain metastases ADC value of combined MRI features, explore the differential points between the two; dynamic of intracranial tuberculosis was observed in the process of anti-TB treatment in the evolution of an accurate grasp of the changes in characteristics of tuberculosis, to provide a scientific basis for clinical treatment. Materials and Methods In this study, collected from September 2009 to February 2011 in Beijing Chest Hospital diagnosed with intracranial TB cases in 72 cases, and collected 35 cases of lung cancer intracranial metastatic tumors as the control group. GE Signa HDxt 1.5 T superconducting magnetic resonance scanner 8NVHEAD NECK coil MRI examination, all patients underwent conventional MRI, T1WI enhancement DWI scan. Outcome measures included MRI features of intracranial tuberculosis; measurement the brain parenchyma tuberculosis and lung cancer with brain metastasis ADC value; 2, 4, 6, and 9 months after the anti-TB treatment dynamic brain MRI protracted illness or heavier extended observation of the absorption or the progress of time, the evaluation of the lesion and its surrounding edema. The statistical method of measurement data using t test, count data using χ2 test. Results (1) intracranial tuberculosis selected 72 cases of tuberculosis, 38 cases of pure brain parenchyma: showed multiple distributed widely, ranging from about the size of 0.1cm ~ 5.0cm, 47.9% of lesions ≤ 0.3cm, 37.4% lesions 0.3cm ~ 1cm lesions ≥ 1.0cm of 14.7%, according to the size of the lesion and MRI performance will be divided into three types of \MRI signal characteristics vary according to the material composition of the lesion center, T1 enhanced scan tuberculous nodules were relatively uniform strengthen the wall ring enhancement while the center is not enhanced lesion center measured ADC values ??are greater than the contralateral normal brain parenchyma ADC value, The difference was statistically significant; mere 24 cases of tuberculous meningitis: strengthen the basilar pool meningeal main part of meningeal nodules; 10 cases of mixed: at the same time have more than two types of MRI features. (2) 35 cases of lung cancer with brain metastasis center ADC value is higher than the ring enhancement associated with the center of the solid lesions of tuberculosis center, while below the ring enhancement associated with the liquid center tuberculous lesions Center ADC value, wall and edema ADC values ??were higher than the ring strengthen tuberculosis stove, and the differences were statistically significant. (3) Dynamic MRI observation of 38 cases. ≤ 0.3cm (1) simple cerebral substance of tuberculosis miliary, 46.8% of the rate of disappearance of 3 months, 6 months disappearance rate of 78.6% to which uniform disappeared strengthen the miliary March, 73.5%; 0.3cm to 1cm nodule three months the disappearance rate of 32.0 %, the disappearance of the 6-month rate of 48.5%; lesions surrounding edema in the rate of disappearance of 3 and 6 months were 57.9%, 84.2%. ② lesions appear contradictory development or increase, are \③ tuberculous meningitis than simply the brain parenchyma tuberculosis treatment effect difference four months has not been the meningeal lesions completely absorbed cases. Conclusion: the miliary, multiple nodular tuberculoma three kinds of typing, you can imaging findings of the brain parenchyma tuberculosis described more completely objective; ADC values ??and MRI features help metastases identification; dynamic MRI can accurately grasp intracranial tuberculosis Changes.

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CLC: > Medicine, health > Clinical > Diagnostics > Diagnostic Imaging > Magnetic resonance imaging
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