Department of Radiology, IRCCS, Ospedale Pediatrico Bambino Gesù, Piazza Sant'Onofrio 4, 00100, Rome, Italy.
Radiol Med. 2012 Jun;117(4):669-78. doi: 10.1007/s11547-011-0743-0. Epub 2011 Nov 17.
The aim of this paper is to describe the imaging features of central nervous system (CNS) tuberculosis on computed tomography (CT) and magnetic resonance imaging (MRI) studies in non-HIV-positive children.
A retrospective descriptive evaluation was conducted on imaging studies obtained from ten children admitted to our hospital over a 6-year period who fulfilled criteria for a diagnosis of CNS tuberculosis. Data were collected with regard to patients' clinical, laboratory and demographic characteristics, as well as results of radiological investigation.
We studied ten children, of whom five were boys and five were girls and whose mean age was 4 (range 7 months to 16) years. Neuroradiological findings on the first imaging study were basal meningeal enhancement (100%), hydrocephalus (70%), infarcts (90%), tuberculomas (40%) and cranial nerve involvement (20%). Follow-up studies revealed basal meningeal enhancement, hydrocephalus, and infarcts in all patients, tuberculomas in 70% and cranial nerve involvement in 50%. Only one patient showed a pattern of miliary tuberculosis.
CNS tuberculosis is still an important cause of childhood morbidity and mortality even in nonimmunosuppressed children. Because prompt diagnosis results in earlier treatment, it is crucial to be aware of tuberculous meningitis and its complications at imaging, especially because of the impact on patients' prognosis.
本研究旨在描述非 HIV 阳性儿童中枢神经系统（CNS）结核的 CT 和 MRI 影像学特征。
回顾性分析了我院 6 年间收治的 10 例符合 CNS 结核诊断标准的患儿的影像学资料，对其临床、实验室及人口统计学特征，以及影像学检查结果进行了收集。
研究共纳入 10 例患儿，男 5 例，女 5 例，平均年龄 4 岁（7 个月至 16 岁）。首次影像学检查的神经放射学表现为基底脑膜强化（100%）、脑积水（70%）、梗死（90%）、结核瘤（40%）和颅神经受累（20%）。随访研究显示所有患者均存在基底脑膜强化、脑积水和梗死，70%的患者存在结核瘤，50%的患者存在颅神经受累。仅有 1 例患者表现为粟粒性结核。
即使在非免疫抑制的儿童中，CNS 结核仍然是导致儿童发病和死亡的重要原因。由于及时诊断可尽早治疗，因此了解影像学上结核性脑膜炎及其并发症至关重要，尤其是因为这会影响患者的预后。
