title: The diagnosis of brain tuberculoma by (1)H-magnetic resonance spectroscopy.
abstract: Toddlers are more prone to develop severe and extrapulmonary tuberculosis (TB) than older children. This is partially explained by differences in the immune response. Early and specific diagnosis is essential to start adequate treatment, especially if the central nervous system (CNS) is involved. The lack of sputum production and inherent dangers or impossibility of sampling CNS lesions may delay diagnosis. In addition, the magnetic resonance imaging (MRI) features of TB abscesses are non-specific and may mimic abscesses of other infectious etiology. (1)H-magnetic resonance spectroscopy ((1)H-MRS) may increase specificity of diagnosis by identifying lipids within the lesions that are considered characteristic for TB. Therefore, we studied four children with presumable CNS-TB with MRI and (1)H-MRS. In vivo and in vitro (1)H-MRS showed elevated lipid peaks within the TB lesions.
  
  
  CONCLUSIONS
  (1)H-MRS allows to non-invasively identifying TB with high specificity and may allow early installment of targeted antimicrobial treatment.
authors.affiliation: Division of Pediatrics, Jayavarman VII Hospital, Kantha Bopha Children's Hospital, Siem Reap, Cambodia.
authors.forename: Ky
authors.initials: K
authors.lastname: Santy
authors.forename: Phang
authors.initials: P
authors.lastname: Nan
authors.forename: Yay
authors.initials: Y
authors.lastname: Chantana
authors.forename: Denis
authors.initials: D
authors.lastname: Laurent
authors.forename: David
authors.initials: D
authors.lastname: Nadal
authors.forename: Beat
authors.initials: B
authors.lastname: Richner
mesh_terms: D001921:Brain / Q000473:pathology; D001927:Brain Diseases / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D016862:Tuberculoma, Intracranial / Q000175:diagnosis*