CT and MR imaging of gastrointestinal tuberculosis

The purpose of this study was to describe the CT and MR imaging findings of tuberculosis of the gastrointestinal tract. Abdominal and pelvic CT scans and MRI studies of 6 patients with histopathological and microbiological proven intestinal tuberculosis were reviewed by two radiologists in consensus. Location and pattern of bowel wall involvement, signal intensities in relation to the normal bowel wall, pattern of enhancement and associated abdominal abnormalities were evaluated. Gastrointestinal tract tuberculosis may be limited to one bowel segment, with the cecum and ileocecal valve as the predominant site of disease, or may involve multiple bowel segments. Asymmetric thickening of the bowel wall is a common finding. Associated findings include pericecal and mesenteric fat stranding, regional lymphadenopathy showing peripheral, heterogeneous and/or homogeneous enhancement patterns and less commonly, tuberculous 'dry plastic' peritonitis. On magnetic resonance (MR) imaging, tuberculous bowel involvement results in intermediate decreased signal intensities on T1-weighted images, and intermediate increased, slight heterogeneous signal intensities on T2-weighted images. On contrast-enhanced images, slight heterogeneous enhancement is seen.