Related Experiment Video
Updated: Sep 6, 2026
Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid for the Detection of Central Nervous System Pathogens
Published on: April 17, 2026
Neuroradiological Findings in Central Nervous System Tuberculosis: A Systematic Review and Meta-analysis Comparing
Pedro Henrique Abreu Tiradentes1, Fabiano Reis2, Hortência De Jesus Ferreira2
1From the Department of Radiology and Oncology (P.H.A.T., F.R., H.D.J.F.), Universidade Estadual de Campinas, Campinas, SP, Brazil; Department of Radiology and Diagnostic Imaging (J.A.D., M.D.L.R.), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Department of Radiology (M.D.), Réseau Hospitalier Neuchâtelois, Neuchâtel, Switzerland and Edward B. Singleton Department of Radiology (T.A.G.M.H.), Texas Children's Hospital and Baylor College of Medicine, Houston, TX, United States of America. phtiradentes@hotmail.com.
Background:
Neurotuberculosis is a severe form of extrapulmonary tuberculosis causing significant morbidity and mortality.
Purpose:
To compare the imaging phenotypes of adult and pediatric populations with CNS tuberculosis through a quantitative meta-analysis, and to characterize the broader spectrum of neurotuberculosis radiological findings through a systematic review emphasizing standard and advanced imaging techniques.
Data Sources:
A systematic search was conducted across Embase, LILACS, PubMed, and Scopus databases.
Study Selection:
Following PRISMA guidelines, observational studies detailing CT and MRI findings in CNS tuberculosis were included.
Data Analysis:
Screening and data extraction were conducted using Rayyan and R software. Random-effects meta-analyses calculated pooled prevalence estimates (95% CI) stratified by age (adult vs. pediatric).
Data Synthesis:
From 91 studies (5,955 patients) in the systematic review, 32 low-risk-of-bias studies (1,675 patients: 24 adult, 1,415 patients; 8 pediatric, 260 patients) were meta-analyzed. Weighted mean age (by study sample size) was approximately 32.0 years in adults (23/24 studies reporting age; N=1,301) and 6.0 years in children (8/8 studies; N=260). Pooled prevalence estimates were numerically higher in pediatric than adult cohorts for meningovascular complications, including leptomeningeal enhancement (89% vs. 61%), hydrocephalus (81% vs. 36%), and brain infarctions (65% vs. 33%, with greater proportional cortical involvement). Tuberculomas showed similar prevalence (∼60%, predominantly multiple). Advanced MRI modalities (DWI, 1H-MRS, vessel wall imaging) provided detailed lesion characterization. Spinal involvement was evaluated almost exclusively in adults, precluding a quantitative comparative meta-analysis due to sparse pediatric spinal data.
Limitations:
High heterogeneity across primary studies, geographic concentration in endemic regions, and insufficient pediatric spinal data.
Conclusions:
Neurotuberculosis imaging phenotypes differed numerically by age group, with pediatric cases showing a higher pooled burden of meningovascular complications. While intracranial age-stratified differences were established, comparative spinal analysis was limited by sparse pediatric data.
Related Concept Videos
01:26Pulmonary Tuberculosis IV
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
01:31Pulmonary Tuberculosis III
The first classification is based on the development of the disease, and it includes the following categories: