MRI SPECTRUM OF CENTRAL NERVOUS SYSTEM TUBERCULOSIS AND ROLE OF ADVANCED SEQUENCES IN DIFFERENTIATING CENTRAL NERVOUS SYSTEM TUBERCULOSIS FROM NEUROCYSTICERCOSIS

Dr. Vandana Verma Ahluwalia; Dr Hari Singh; Dr Rachna Pachori

Volume : IX, Issue : IV, April - 2020

MRI SPECTRUM OF CENTRAL NERVOUS SYSTEM TUBERCULOSIS AND ROLE OF ADVANCED SEQUENCES IN DIFFERENTIATING CENTRAL NERVOUS SYSTEM TUBERCULOSIS FROM NEUROCYSTICERCOSIS

Dr. Vandana Verma Ahluwalia, Dr Hari Singh, Dr Rachna Pachori

Abstract :

INTRODUCTION: CNS tuberculosis has a vast spectrum of appearance with NCC as one of the greatest mimickers. The purpose of this study was to revisit the vast spectrum of appearance of CNS tuberculosis and special emphasis was given to the utilization of advanced MRI sequences like DWI and MRS in differentiating CNS tuberculosis from NCC. METHODS: This descriptive study was performed over a period of two years and the data from 60 patients was recorded and analyzed to calculate the relative proportions of various imaging features of CNS tuberculosis and to assess the role of DWI / MRS to differentiate it from NCC. RESULTS: Most common feature of CNS tuberculosis was tuberculoma followed by meningitis and vasculitis. The DWI showed diffusion restriction in (40%) cases of tuberculosis and (10%) cases of NCC. 80% cases of tuberculosis showed presence of lipid peak. While acetate, succinate and lactate peak were seen in cases of NCC. CONCLUSION: Conventional imaging is helpful in differentiating 33.3% of cases and shortcomings of conventional images can be overcome by advanced MRI sequences like DWI and MRS. The lipid peak detected on MRS showed high accuracy for tuberculosis in our study and NCC can be confidently ruled out in the presence of lipid peak