Tuberculosis MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Mashal Awais, M.D.[2]; Alejandro Lemor, M.D. [3]

## Overview[edit | edit source]

MRI is indicated for the diagnosis of extra-pulmonary tuberculosis, such as CNS tuberculosis, parotid gland tuberculosis osteoarticular tuberculosis, and Pott's disease.

## MRI[edit | edit source]

#### CNS Tuberculosis[edit | edit source]

* MRI is often ordered in case of CNS infection with tuberculosis.
* The following findings may be seen in CNS tuberculosis:[1]

* Ring-enhancing mass in T2 and hypodense lesion in case of a non-caseating tuberculoma.
* A caseating tuberculoma can show a hypodense lesion in both T1 and T2.
* Cerebral edema
* Diffuse enhancement in case of meningitis

CNS Tuberculoma
Image courtesy of Dr Praveen Jha, Radiopedia. (original file here) Creative Commons BY-SA-NC | CNS Tuberculoma
Image courtesy of Dr Praveen Jha, Radiopedia. (original file here) Creative Commons BY-SA-NC

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#### Pott's Disease[edit | edit source]

* Spinal MRI is the imaging test of choice in case of tuberculosis involving spine.
* Findings include: [2]

* Endplate irregularity
* Irregular anterior aspect of the vertebral bodies
* Edema and enhancement of the bone marrow
* Destruction of the vertebral body in severe cases

Spinal Tuberculosis
Image courtesy of Dr Hani Salam, Radiopedia. (original file here) Creative Commons BY-SA-NC | Spinal Tuberculosis
Image courtesy of Dr Hani Salam, Radiopedia. (original file here) Creative Commons BY-SA-NC | Spinal Tuberculosis
Image courtesy of Dr Hani Salam, Radiopedia. (original file here) Creative Commons BY-SA-NC

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#### Osteoarticular Tuberculosis[edit | edit source]

* Abnormal findings on MRI in osteoarticular tuberculosis include:[3]

* Demineralization

* Joint space narrowing

* Bone and cartilage erosion

* Calcifications

#### Parotid Gland Tuberculosis[edit | edit source]

* Tuberculosis infection of the parotid gland may resemble a parotid neoplasm.
* The MRI shown below reveals a well-defined mass lesion, measuring 16 × 21 × 30 mm in size, hypointense on T1-weighted images, and hyperintense on T2-weighted images with homogenous contrast enhancement, present in the posterior part of the superficial lobe of the right parotid gland.[4]

Image courtesy of Wikimedia Commons.

## References[edit | edit source]

1. ↑ Burrill, Joshua; Williams, Christopher J.; Bain, Gillian; Conder, Gabriel; Hine, Andrew L.; Misra, Rakesh R. (2007). "Tuberculosis: A Radiologic Review1". RadioGraphics. 27 (5): 1255–1273. doi:10.1148/rg.275065176. ISSN 0271-5333.
2. ↑ Torres C, Riascos R, Figueroa R, Gupta RK (2014). "Central nervous system tuberculosis". Top Magn Reson Imaging. 23 (3): 173–89. doi:10.1097/RMR.0000000000000023. PMID 24887691.CS1 maint: Multiple names: authors list (link)
3. ↑ Grubisić F, Borić I, Segota A, Kruslin B, Grazio S (2014). "An unusual manifestation of osteoarticular tuberculosis: case report". Acta Clin Croat. 53 (2): 237–41. PMID 25163241.CS1 maint: Multiple names: authors list (link)
4. ↑ Birkent, Hakan; Karahatay, Serdar; Akcam, Timur; Durmaz, Abdullah; Ongoru, Onder (2008). "Primary parotid tuberculosis mimicking parotid neoplasm: a case report". Journal of Medical Case Reports. 2 (1): 62. doi:10.1186/1752-1947-2-62. ISSN 1752-1947.

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