MR imaging of central nervous system tuberculosis

This paper reports plain and Gd-DTPA-enchanted MR imaging performed with a 2.0-T unit in 26 patients with intracranial tuberculosis and seven with spinal tuberculosis radiculomyelitis, and images were compared with CT scans. In intracranial tuberculosis, MR imaging depicted a few more hemorrhagic infarcts, meningeal enhancements, and granulomas than CT did, but it missed small calcifications. In spinal tuberculosis radiculomyelitis, MR imaging demonstrated enhancement of the dura-arachnoid complex (five of seven cases), intradural granulomas (three of seven), and segmental cord swelling with enhancement suggesting tuberculosis myelitis, cord infarct (two of seven), which were not obvious on CT myelograms. Without Gd-DTPA enhancement, both cranial and spinal MR imaging was generally insensitive in the detection of active meningeal inflammation and granulomas