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中枢神经系统和脊髓结核:重新审视一种重要疾病。

Central nervous system and spinal cord tuberculosis: Revisiting an important disease.

机构信息

Department of Diagnostic Radiology, Hospital de Clinicas, Federal University of Parana, Curitiba, Parana, Brazil.

Department of Diagnostic Radiology, Hospital de Clinicas, Federal University of Parana, Curitiba, Parana, Brazil.

出版信息

Clin Imaging. 2021 Jan;69:158-168. doi: 10.1016/j.clinimag.2020.07.020. Epub 2020 Jul 29.

Abstract

Tuberculosis is a worldwide pandemic. Estimated that about 25% humans are colonized by Mycobacterium tuberculosis and about 1% are believed to develop the infection in the central nervous system (CNS-TB). Given the importance of this disease and its high levels of morbidity and mortality, it is imperative that every radiologist must be reminded of the most common findings of CNS-TB as there are several related differential diagnoses for this disease. The most common form CNS-TB is tuberculous meningitis (TBM), characterized mostly by basal meningitis, but infarction, hydrocephalus and tuberculomas could be present. Intracerebral tuberculosis is characterized by tuberculomas that can have different imaging features according to their stage. Vascular and spinal complications of tuberculosis are also reported. This review compiles the classic and unusual findings regarding CNS-TB together with new diagnostic scores in which neuroimaging have an important role.

摘要

结核病是一种全球性的大流行病。据估计,约有 25%的人类被结核分枝杆菌定植,约 1%的人被认为会在中枢神经系统(CNS-TB)中感染。鉴于这种疾病的重要性及其高发病率和死亡率,每个放射科医生都必须牢记 CNS-TB 的最常见表现,因为这种疾病有几个相关的鉴别诊断。CNS-TB 最常见的形式是结核性脑膜炎(TBM),主要表现为基底脑膜炎,但也可能存在梗死、脑积水和结核瘤。脑内结核的特征是结核瘤,根据其阶段不同,其影像学特征也不同。结核病的血管和脊柱并发症也有报道。本综述汇集了关于 CNS-TB 的经典和不常见的发现,以及神经影像学在其中发挥重要作用的新诊断评分。

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