The Role of Diffusion Tensor Imaging in CNS Tuberculosis.

Area of Science:

• Neurology
• Radiology
• Infectious Diseases

Background:

• Central nervous system (CNS) tuberculosis presents a significant challenge, particularly in high-burden regions like India.
• It is associated with high rates of morbidity and mortality.
• Understanding microstructural white matter changes is crucial for effective management.

Purpose of the Study:

• To investigate the role of diffusion tensor imaging (DTI) in evaluating white matter microstructural alterations in CNS tuberculosis.
• To correlate imaging findings with disease severity and potential clinical outcomes.

Main Methods:

• A cross-sectional observational study was conducted over two years.
• Patients with definite or highly probable tuberculous meningitis were compared with healthy controls.
• Diffusion tensor imaging (DTI) was used to assess white matter integrity.

Main Results:

• Patients with CNS tuberculosis showed significantly reduced fractional anisotropy (FA) values in white matter tracts compared to controls.
• Reduced FA values, especially in the corpus callosum, correlated with the severity of tuberculous meningitis.
• DTI identified distinct patterns of white matter involvement around intraparenchymal lesions.

Conclusions:

• Diffusion tensor imaging (DTI) is valuable for assessing microstructural white matter changes in CNS tuberculosis.
• Fractional anisotropy (FA) values can aid in grading disease severity and predicting treatment outcomes.
• DTI shows potential for early diagnosis and monitoring treatment response in CNS TB.