MR vessel wall imaging in tubercular meningitis

Area of Science:

• Neurology
• Radiology
• Infectious Diseases

Background:

• Tubercular meningitis (TBM) can lead to secondary vasculitis and cerebrovascular complications.
• Vessel wall imaging (VWI) is a technique to visualize these vascular involvements.

Purpose of the Study:

• To investigate detailed findings of VWI in patients with TBM.
• To correlate VWI findings with disease severity, infarctions, and MRA results.

Main Methods:

• Consecutive patients diagnosed with TBM were included.
• High-resolution MR VWI and time-of-flight MRA were performed.
• Statistical analysis was conducted on VWI findings, infarctions, and MRA results.

Main Results:

• Infarctions were present in 48.5% of TBM cases, and vessel wall enhancement was observed in 66.3%.
• Increasing TBM severity correlated with more severe vascular involvement on VWI.
• VWI demonstrated higher sensitivity, while MRA showed higher specificity for detecting vascular complications.

Conclusions:

• VWI can detect tubercular vasculitis through nodular or segmental vessel wall enhancement.
• Integrating VWI into routine MR imaging can enhance early detection and management of TBM-related cerebrovascular complications.
• Improved detection and management may lead to better patient prognosis.