CT features of tuberculous intracranial abscesses in children.
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.


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).


CONCLUSIONS
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.
du Plessis
Jaco
J
Department of Radiology, University of Stellenbosch, Tygerberg Hospital, P.O. Box 19063, Tygerberg 7505, South Africa.
Andronikou
Savvas
S
Wieselthaler
Nicky
N
Theron
Salomine
S
George
Reena
R
Mapukata
Ayanda
A
D001922:Brain Abscess / Q000000981:diagnostic imaging*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016862:Tuberculoma, Intracranial / Q000000981:diagnostic imaging*