Magnetic resonance imaging findings in tuberculous meningoencephalitis.

OBJECTIVE

To evaluate the efficacy of magnetic resonance imaging (MRI) for distinguishing tuberculosis from other types of meningoencephalitis.

PATIENTS AND

METHODS

MRIs of 100 patients with tuberculous (50), pyogenic (33), viral (14), or fungal (3) meningoencephalitis were analyzed independently by 2 radiologists. Number, size, location, signal characteristics, surrounding edema, and contrast enhancement pattern of nodular lesions; location and pattern of meningeal enhancement; extent of infarct or encephalitis and hydrocephalus were evaluated.

RESULTS

Contrast-enhancing nodular lesions were detected in patients with tuberculous (43 of 50 patients), pyogenic (9 of 33), and fungal (3 of 3) infections. No nodules were detected in patients with viral meningoencephalitis. Using the criteria of 1 or more solid rim or homogeneously enhancing nodules smaller than 2 cm, the sensitivity, specificity and accuracy for diagnosing tuberculous meningitis were 86.0%, 90.0% and 88.0%, respectively.

CONCLUSION

Magnetic resonance imaging is useful in distinguishing tuberculous from pyogenic, viral and fungal meningoencephalitis.