Central Nervous System involvement in tuberculosis: An MRI study considering differences between patients with and without Human Immunodeficiency Virus 1 infection
| Autor: | Alessandro Bozzao, Gioia Papale, Andrea Romano, Edoardo Ronconi, Federica Di Stefano, Elisa Pianura, Alberto Di Napoli, Massimo Cristofaro, Vincenzo Schininà, Maria Camilla Rossi Espagnet, Ada Petrone |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Tuberculosis Central nervous system Contrast Media HIV Infections Disease 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Stroke Immunodeficiency Aged Retrospective Studies Aged 80 and over Lung Radiological and Ultrasound Technology medicine.diagnostic_test business.industry virus diseases Magnetic resonance imaging Middle Aged Tuberculosis Central Nervous System medicine.disease Magnetic Resonance Imaging Hydrocephalus medicine.anatomical_structure Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neuroradiology. 47:334-338 |
| ISSN: | 0150-9861 |
| DOI: | 10.1016/j.neurad.2019.07.008 |
| Popis: | Background Magnetic resonance imaging (MRI) is largely used in the diagnosis of central nervous system involvement of tuberculosis (CNSTB), yet there is no MRI comparison study between HIV+ and HIV− patients with CNSTB. The aim of the present study was to identify MRI differences in CNSTB between HIV+ and HIV− patients and possibly find early characteristics that could raise the suspect of this disease. Methods We included all patients admitted in our institution between 2011 and 2018 with confirmed diagnosis of CNSTB, and MRI performed in the first week. Patients with preexisting brain pathology or immunodeficiency not HIV related were excluded. We compared CNSTB MRI features between the two groups. Results Sixty-nine patients were included (19 HIV+; 50 HIV−). Findings in HIV+ group: 6 lung TB, 5 hydrocephalus, 4 meningeal enhancement, 6 stroke, 2 hemorrhages, and 10 tuberculomas. HIV− group: 22 lung tuberculosis, 15 hydrocephalus, 21 meningeal enhancement, 5 stroke, 4 hemorrhages, 20 tuberculomas. The only statistically significant difference between the two groups was in the stroke occurrence, more frequent in the HIV+ group (P = .028), all involving the basal ganglia. Conclusions Stroke involving the basal ganglia best differentiates CNSTB patients who are HIV+ from those HIV−. This finding was not correlated with meningeal enhancement suggesting that small arteries involvement might precede it. Therefore, we think that HIV+ patients with a new onset of stroke should be evaluated for CNSTB. Follow-up MRI should also be planned since meningeal enhancement might appear in later stages of the disease. |
| Databáze: | OpenAIRE |
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