du Plessis Jaco, Andronikou Savvas, Wieselthaler Nicky, Theron Salomine, George Reena, Mapukata Ayanda
Department of Radiology, University of Stellenbosch, Tygerberg Hospital, P.O. Box 19063, Tygerberg 7505, South Africa.
Pediatr Radiol. 2007 Feb;37(2):167-72. doi: 10.1007/s00247-006-0370-4. Epub 2006 Dec 16.
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.
To report the CT features of eight intracranial TB lesions in children initially diagnosed as neoplasms and eventually treated as TB abscesses.
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.
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).
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.
颅内结核性（TB）脓肿在CT和MRI上仍会造成诊断难题，因为它们可能类似肿瘤。识别结核性脓肿可促使进一步的影像学检查和适当的治疗试验，并可能减少活检的必要性。
报告8例最初被诊断为肿瘤、最终被当作结核性脓肿治疗的儿童颅内结核病变的CT特征。
我们对最初CT诊断为颅内肿瘤、随后被诊断为结核性脓肿的儿童进行了为期3年的回顾性研究。
60例最初CT诊断为肿瘤的患者中，有8例被误诊，最终经活检或抗结核治疗试验后确定为结核性脓肿。这些病变最一致的表现为低密度（n = 5）、环形强化（n = 8）、位于大脑半球（n = 7）、占位效应（n = 6）、周围水肿（n = 5）以及无软组织密度肿块（n = 8）。
在流行地区，CT上有这些表现的颅内病变在考虑活检之前应进行进一步的影像学检查，并可能进行抗结核治疗试验。
