Single photon emission computed tomography in tuberculous meningitis

Area of Science:

• Neurology
• Infectious Diseases
• Radiology

Background:

• Limited data exists on single photon emission computed tomography (SPECT) findings in tuberculous meningitis.
• Tuberculous meningitis (TBM) is a severe infection requiring accurate diagnostic tools.
• This study aims to elucidate SPECT findings in TBM and their correlation with clinical and radiological data.

Purpose of the Study:

• To report and analyze single photon emission computed tomography (SPECT) findings in patients diagnosed with tuberculous meningitis.
• To correlate SPECT results with clinical presentation, radiological imaging (CT/MRI), and patient outcomes.
• To assess the utility of SPECT in evaluating perfusion abnormalities in TBM.

Main Methods:

• Seventeen patients with confirmed tuberculous meningitis underwent computed tomography (CT) and/or magnetic resonance imaging (MRI), and SPECT using (99m)Tc-ethylene cystine dimer.
• Patients were assessed based on clinical, radiological, and laboratory criteria.
• Patient outcomes were categorized using the Barthel index (BI) at three-month follow-up.

Main Results:

• SPECT studies were abnormal in 15 out of 17 patients, most frequently showing hypoperfusion in the basal ganglia (14 patients) and cortex (10 patients).
• CT revealed abnormalities in 11 out of 16 patients, including hydrocephalus, basal exudates, and infarctions.
• SPECT findings did not correlate with the stage of tuberculous meningitis or the three-month patient outcome (complete, partial, or poor recovery).

Conclusions:

• Subcortical and cortical hypoperfusion are common findings on SPECT in tuberculous meningitis.
• Despite frequent abnormalities, SPECT findings do not reliably predict disease stage or short-term patient outcomes in TBM.
• Further research may be needed to refine the role of SPECT in managing TBM.