Abstract
Background
Intracranial tuberculous (TB) abscesses still cause a diagnostic dilemma on both CT and MRI as they may mimic neoplasms. Recognition of TB abscesses may prompt further imaging and appropriate trial of therapy, and may reduce the need for biopsy.
Objective
To report the CT features of eight intracranial TB lesions in children initially diagnosed as neoplasms and eventually treated as TB abscesses.
Materials and methods
We undertook a 3-year retrospective review of children with an initial CT diagnosis of intracranial neoplasm who were subsequently diagnosed as having TB abscesses.
Results
Eight patients out of 60 with an initial diagnosis of a neoplasm on CT were misdiagnosed and were ultimately determined to have TB abscesses after biopsy or a trial of anti-TB therapy. The most consistent constellation of findings for the lesions were low density (n = 5), ring enhancement (n = 8), cerebral hemisphere location (n = 7), mass effect (n = 6), surrounding oedema (n = 5) and absence of a soft-tissue-density mass (n = 8).
Conclusion
In endemic regions, intracranial lesions with these appearances on CT should undergo further imaging and possibly a trial of anti-TB therapy before considering biopsy.
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References
Wasay M, Kheleani BA, Moolani MK et al (2003) Brain CT and MRI findings in 100 consecutive patients with intracranial tuberculoma. J Neuroimaging 13:240–247
Bernaerts A, Vanhoenacker FM, Parizel PM et al (2003) Tuberculosis of the central nervous system: overview of the neuroradiological findings. Eur Radiol 13:1876–1890
Gupta RK, Prakash M, Mishra AM et al (2005) Role of diffusion weighted imaging in differentiation of intracranial tuberculoma and tuberculous abscess from cysticercus granulomas – a report of more than 100 lesions. Eur Radiol 55:384–392
Talamas O, Del Brutto OH, Garcia-Ramos G (1989) Brainstem tuberculoma. An analysis of 11 patients. Arch Neurol 46:529–535
Brismar J, Hugosson C, Larsson SG et al (1996) Imaging of tuberculosis. III. Tuberculosis as a mimicker of brain tumour. Acta Radiol 37:496–505
Artico M, De Caro GM, Carloia S et al (1999) Advances in diagnosis, treatment and prognosis of intracerebral tuberculomas in the last 50 years. Report of 21 cases. Neurochirurgie 45:129–133
Welchman JM (1979) CT of intracranial tuberculomata. Clin Radiol 30:567–573
Jinkins JR (1991) Computed tomography of intracranial tuberculosis. Neuroradiology 33:126–135
Gupta RK (1988) MR imaging of intracranial tuberculomas. J Comput Assist Tomogr 12:280–285
Srinivasula S, Rajshekar V, Chandy MJ et al (1994) Predictive value of computed tomography-based diagnosis of intracranial tuberculomas. Neurosurgery 35:845–849
Domingo Z, Peter JC (1989) Intracranial tuberculomas. Pediatr Neurosci 15:161–167
Whittle IR, Allsop JL, Besser M (1983) Tuberculoma mimicking a pinealoma. J Neurosurg 59:875–878
Luh GY, Bird CR (1999) Imaging brain tumours in the pediatric population. Neuroimaging Clin North Am 9:691–715
Loevner LA (1999) Imaging features of posterior fossa neoplasms in children and adults. Semin Roentgenol 34:84–101
Zimmerman RA (1996) Neuroimaging of brainstem glioma. Pediatr Neurosurg 25:83–92
Draouat S, Abdenabi B, Ghanem M et al (1987) CT of cerebral tuberculoma. J Comput Assist Tomogr 11:594–597
Yang PJ, Reger KM, Seeger JF et al (1987) Brain abscess: an atypical CT appearance of CNS tuberculosis. AJNR 8:919–920
Sadeghi N, Rorive S, Lefranc F (2003) Intracranial tuberculoma: is diffusion-weighted imaging useful in the diagnosis? Eur Radiol 13:2049–2050
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du Plessis, J., Andronikou, S., Wieselthaler, N. et al. CT features of tuberculous intracranial abscesses in children. Pediatr Radiol 37, 167–172 (2007). https://doi.org/10.1007/s00247-006-0370-4
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DOI: https://doi.org/10.1007/s00247-006-0370-4