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Value of MRI and cerebrospinal fluid examination in evaluating the curative effect of anti-tuberculosis treatment on patients with intracranial tuberculosis
JI Junyu  YUAN Shuai  SHEN Jing  ZHAO Yuming 

Cite this article as: Ji JY, Yuan S, Shen J, et al. Value of MRI and cerebrospinal fluid examination in evaluating the curative effect of anti-tuberculosis treatment on patients with intracranial tuberculosis[J]. Chin J Magn Reson Imaging, 2021, 12(5): 65-68. DOI:10.12015/issn.1674-8034.2021.05.014.


[Abstract] Objective To investigate the value of MRI and cerebrospinal fluid examination in evaluating the curative effect of anti-tuberculosis treatment on patients with intracranial tuberculosis. Materials andMethods A total of 400 patients with intracranial tuberculosis who received MRI in the radiology department of the hospital from May 2012 to May 2017 were enrolled in the study. According to the type of intracranial tuberculosis, they were divided into simple brain parenchymal tuberculosis, tuberculous meningitis and mixed intracranial tuberculosis. The MRI characteristics of different types of intracranial tuberculosis and the dynamic MRI changes during anti-tuberculosis treatment were analyzed. Patients' cerebrospinal fluid samples were collected for biochemical and cytological examinations. Changes in cerebrospinal fluid indicators during anti-tuberculosis treatment were analyzed, and the value of MRI and cerebrospinal fluid examination in evaluating the curative effect of anti-tuberculosis treatment was summarized.Results In 400 cases with intracranial tuberculosis, there were 179 cases (44.75%) with simple brain parenchymal tuberculosis, 71 cases (17.75%) with tuberculous meningitis and 150 cases (37.50%) with mixed intracranial tuberculosis. A total of 425 lesions were detected in patients with simple brain parenchymal tuberculosis, including 196 of miliary type, 167 of nodular type, and 62 tuberculomas. MRI findings were as follows: even signals, slightly longer or equal T1 signals, long or slightly longer T2 signals; uneven signals, long or equal T1 signals and long T2 signals in the center, slightly longer or equal T1 and T2 signals at the edge. Enhanced scan showed homogenous enhancement, circular enhancement and solid enhancement. The disappearance rate of miliary lesions was higher than that of nodular ones and tuberculoma at 1 month, 3 months and 6 months after treatment. MRI of patients with tuberculous meningitis showed gyrus-like high signal on T2WI, equal or low signal on T1WI. After enhanced scan, the meninges showed radial enhancement, dominated by enhancement in the suprasellar cistern meninge, ambient cistern meninge, and quadruplet cisternal meninge. After treatment, meninge enhancement and thickening were relieved, and meningeal lesions were improved. The MRI findings of patients with mixed intracranial tuberculosis had both the MRI signs of simple brain parenchymal tuberculosis and tuberculous meningitis. After treatment, the meningeal lesions were improved, and some had enlarged or increased meningeal nodules. One month, 3 months and 6 months after treatment, the levels of protein, white blood cells, neutrophils and lymphocytes in patients with intracranial tuberculosis decreased, while the levels of chloride and glucose increased (P＜0.05).Conclusions Different types of intracranial tuberculosis have obvious MRI features. Having a clear understanding of dynamic MRI and cerebrospinal fluid changes during anti-tuberculosis treatment is helpful for the evaluation and prediction of clinical anti-tuberculosis treatment effect.
[Keywords] Intracranial tuberculosis；brain parenchymal tuberculosis；tuberculous meningitis；magnetic resonance imaging；cerebrospinal fluid；cytology

JI Junyu*   YUAN Shuai   SHEN Jing   ZHAO Yuming  

Department of Radiology, Hebei Chest Hospital, Shijiazhuang 050041, China

Ji JY, Email: jijunyu2020@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS Key Research Project of Medical Science in Hebei Province (No. 20170430).
Received  2020-12-10
Accepted  2021-03-25
DOI: 10.12015/issn.1674-8034.2021.05.014
Cite this article as: Ji JY, Yuan S, Shen J, et al. Value of MRI and cerebrospinal fluid examination in evaluating the curative effect of anti-tuberculosis treatment on patients with intracranial tuberculosis[J]. Chin J Magn Reson Imaging, 2021, 12(5): 65-68. DOI:10.12015/issn.1674-8034.2021.05.014.

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