Perfusion magnetic resonance imaging in intracerebral parenchymal tuberculosis: preliminary findings.
OBJECTIVE
To study the vascular perfusion patterns of focal intracerebral tubercular lesions using echoplanar magnetic resonance (MR) imaging-derived relative cerebral blood volume (rCBV) maps.


METHODS
Seventeen focal tubercular lesions were evaluated with conventional and perfusion-weighted MR imaging on a 1.5-T MR system. The rCBVs of the center, peripheral wall, and perilesional white matter were calculated from the perfusion MR-derived data. Perfusion MR imaging findings as depicted on the rCBV maps were qualitatively compared with those of conventional MR findings.


RESULTS
Eleven of the 17 lesions demonstrated vascularity greater than that of the contralateral white matter on rCBV maps. The mean of the measured rCBV values of the peripheral wall and center of the lesions was 2.5 +/- 1.42 and 0.33 +/- 0.3 (mean +/- SD), respectively. Most of the hypervascular lesions (8) revealed a concentric peripheral wall having alternating hypointense and hyperintense signal intensity rims surrounding a variable intensity center on T2-weighted images. All the lesions having a nodular enhancing pattern (4) were hypervascular.


CONCLUSIONS
Focal cerebral tubercular lesions can have variable vascularity as shown on perfusion MR-derived rCBV maps. It may be difficult to differentiate hypervascular lesions from cerebral tumors in some patients based on perfusion MR imaging alone.
Batra
Arun
A
NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences, Defence Research and Development Organization, Timarpur, Delhi, India. abatra2@hotmail.com
Tripathi
Rajendra P
RP
D000293:Adolescent; D000328:Adult; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography; D012680:Sensitivity and Specificity; D020306:Tuberculosis, Central Nervous System / Q000000981:diagnostic imaging*