Wasay Mohammad, Ajmal Saad, Taqui Ather M, Uddin Najam, Azam Iqbal, Husen Yousuf, Nizami Syed Qamaruddin
Department of Neurology, The Aga Khan University, Karachi, Pakistan.
J Child Neurol. 2010 May;25(5):581-6. doi: 10.1177/0883073809340921. Epub 2009 Sep 30.
The authors conducted this study to identify whether bacille Calmette-Guérin (BCG) vaccination leads to an altered spectrum of neuroimaging findings outcome in pediatric patients with tuberculous meningitis. This retrospective study was conducted through chart review and review of computed tomography (CT) scans and magnetic resonance imaging (MRI) of patients with confirmed central nervous system tuberculosis from the year 1992 to 2005, at a large tertiary care hospital in Karachi, Pakistan. A total of 108 pediatric patients with tuberculous meningitis were included in the analysis. Of the 108 patients, 63 (58.3%) were male and 45 (41.7%) had received bacille Calmette-Guérin vaccination. There was no difference in terms of severity of clinical presentation and outcome between vaccinated and unvaccinated group. There were no significant differences in CT or MRI findings between the 2 groups except for tuberculomas on MRI, which were significantly higher in the non-bacille Calmette-Guérin vaccinated group (52.2% vs 22.7%, P = .042). Bacille Calmette-Guérin vaccination appears to translate into less tuberculoma formation on MRI.
作者开展此项研究，以确定卡介苗（BCG）接种是否会使结核性脑膜炎患儿的神经影像学检查结果谱发生改变。这项回顾性研究通过查阅病历以及回顾1992年至2005年期间在巴基斯坦卡拉奇一家大型三级护理医院确诊为中枢神经系统结核患者的计算机断层扫描（CT）和磁共振成像（MRI）进行。共有108例结核性脑膜炎患儿纳入分析。在这108例患者中，63例（58.3%）为男性，45例（41.7%）接种过卡介苗。接种组和未接种组在临床表现严重程度及预后方面无差异。两组在CT或MRI检查结果上无显著差异，但MRI上的结核瘤除外，未接种卡介苗组的结核瘤明显更多（52.2%对22.7%，P = 0.042）。卡介苗接种似乎可使MRI上结核瘤形成减少。
