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MRI to demonstrate diagnostic features and complications of TBM not seen with CT

Manana Pienaar1, Savvas Andronikou, Ronald van Toorn

  • 1Department of Radiology, Tygerberg Hospital, University of Stellenbosch, Stellenbosch, South Africa.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|December 25, 2008
PubMed
Abstract

Insights

Magnetic resonance imaging (MRI) is superior to computed tomography (CT) for diagnosing tuberculous meningitis (TBM) in children, detecting more infarcts and basal enhancement. CT remains useful for detecting hydrocephalus.

Area of Science:

  • Pediatric Neurology
  • Neuroradiology
  • Infectious Diseases

Background:

  • Computed tomography (CT) findings in children with tuberculous meningitis (TBM) are often non-specific or normal.
  • Magnetic resonance imaging (MRI) offers higher sensitivity for TBM diagnosis and infarct detection compared to CT.

Purpose of the Study:

  • To compare CT and MRI findings in pediatric TBM.
  • To identify TBM features and complications better visualized by MRI than CT.

Main Methods:

  • Retrospective, blinded evaluation of CT and MRI scans in 30 children with TBM.
  • Direct comparison of imaging findings between CT and MRI.

Main Results:

  • MRI detected more cases of basal enhancement and infarcts than CT.
  • MRI identified 104 additional infarct sites (89 acute, visualized on diffusion-weighted imaging), including basal ganglia and brainstem infarcts.
  • Hydrocephalus detection was comparable between MRI and CT.

Conclusions:

  • MRI is superior to CT for diagnosing TBM and assessing prognosis due to enhanced visualization of infarcts.
  • CT plays a role in acute settings for hydrocephalus detection to guide surgical management.

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