Abstract
Background: Magnetic resonance imaging (MRI) is largely used in the diagnosis of central nervous system involvement of tuberculosis (CNSTB), yet there is no MRI comparison study between HIV+ and HIV− patients with CNSTB. The aim of the present study was to identify MRI differences in CNSTB between HIV+ and HIV− patients and possibly find early characteristics that could raise the suspect of this disease. Methods: We included all patients admitted in our institution between 2011 and 2018 with confirmed diagnosis of CNSTB, and MRI performed in the first week. Patients with preexisting brain pathology or immunodeficiency not HIV related were excluded. We compared CNSTB MRI features between the two groups. Results: Sixty-nine patients were included (19 HIV+; 50 HIV−). Findings in HIV+ group: 6 lung TB, 5 hydrocephalus, 4 meningeal enhancement, 6 stroke, 2 hemorrhages, and 10 tuberculomas. HIV− group: 22 lung tuberculosis, 15 hydrocephalus, 21 meningeal enhancement, 5 stroke, 4 hemorrhages, 20 tuberculomas. The only statistically significant difference between the two groups was in the stroke occurrence, more frequent in the HIV+ group (P =.028), all involving the basal ganglia. Conclusions: Stroke involving the basal ganglia best differentiates CNSTB patients who are HIV+ from those HIV−. This finding was not correlated with meningeal enhancement suggesting that small arteries involvement might precede it. Therefore, we think that HIV+ patients with a new onset of stroke should be evaluated for CNSTB. Follow-up MRI should also be planned since meningeal enhancement might appear in later stages of the disease.
| Original language | English |
|---|---|
| Pages (from-to) | 1-18 |
| Number of pages | 18 |
| Journal | Journal of Neuroradiology |
| DOIs | |
| Publication status | Accepted/In press - Jan 1 2019 |
Fingerprint
Keywords
- HIV
- MRI
- Stroke
- Tuberculosis
ASJC Scopus subject areas
- Radiological and Ultrasound Technology
- Radiology Nuclear Medicine and imaging
- Clinical Neurology
Cite this
Central Nervous System involvement in tuberculosis : An MRI study considering differences between patients with and without Human Immunodeficiency Virus 1 infection. / Di Napoli, Alberto; Cristofaro, Massimo; Romano, Andrea; Pianura, Elisa; Papale, Gioia; Di Stefano, Federica; Ronconi, Edoardo; Petrone, Ada; Rossi Espagnet, Maria Camilla; Schininà, Vincenzo; Bozzao, Alessandro.
In: Journal of Neuroradiology, 01.01.2019, p. 1-18.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Central Nervous System involvement in tuberculosis
T2 - An MRI study considering differences between patients with and without Human Immunodeficiency Virus 1 infection
AU - Di Napoli, Alberto
AU - Cristofaro, Massimo
AU - Romano, Andrea
AU - Pianura, Elisa
AU - Papale, Gioia
AU - Di Stefano, Federica
AU - Ronconi, Edoardo
AU - Petrone, Ada
AU - Rossi Espagnet, Maria Camilla
AU - Schininà, Vincenzo
AU - Bozzao, Alessandro
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: Magnetic resonance imaging (MRI) is largely used in the diagnosis of central nervous system involvement of tuberculosis (CNSTB), yet there is no MRI comparison study between HIV+ and HIV− patients with CNSTB. The aim of the present study was to identify MRI differences in CNSTB between HIV+ and HIV− patients and possibly find early characteristics that could raise the suspect of this disease. Methods: We included all patients admitted in our institution between 2011 and 2018 with confirmed diagnosis of CNSTB, and MRI performed in the first week. Patients with preexisting brain pathology or immunodeficiency not HIV related were excluded. We compared CNSTB MRI features between the two groups. Results: Sixty-nine patients were included (19 HIV+; 50 HIV−). Findings in HIV+ group: 6 lung TB, 5 hydrocephalus, 4 meningeal enhancement, 6 stroke, 2 hemorrhages, and 10 tuberculomas. HIV− group: 22 lung tuberculosis, 15 hydrocephalus, 21 meningeal enhancement, 5 stroke, 4 hemorrhages, 20 tuberculomas. The only statistically significant difference between the two groups was in the stroke occurrence, more frequent in the HIV+ group (P =.028), all involving the basal ganglia. Conclusions: Stroke involving the basal ganglia best differentiates CNSTB patients who are HIV+ from those HIV−. This finding was not correlated with meningeal enhancement suggesting that small arteries involvement might precede it. Therefore, we think that HIV+ patients with a new onset of stroke should be evaluated for CNSTB. Follow-up MRI should also be planned since meningeal enhancement might appear in later stages of the disease.
AB - Background: Magnetic resonance imaging (MRI) is largely used in the diagnosis of central nervous system involvement of tuberculosis (CNSTB), yet there is no MRI comparison study between HIV+ and HIV− patients with CNSTB. The aim of the present study was to identify MRI differences in CNSTB between HIV+ and HIV− patients and possibly find early characteristics that could raise the suspect of this disease. Methods: We included all patients admitted in our institution between 2011 and 2018 with confirmed diagnosis of CNSTB, and MRI performed in the first week. Patients with preexisting brain pathology or immunodeficiency not HIV related were excluded. We compared CNSTB MRI features between the two groups. Results: Sixty-nine patients were included (19 HIV+; 50 HIV−). Findings in HIV+ group: 6 lung TB, 5 hydrocephalus, 4 meningeal enhancement, 6 stroke, 2 hemorrhages, and 10 tuberculomas. HIV− group: 22 lung tuberculosis, 15 hydrocephalus, 21 meningeal enhancement, 5 stroke, 4 hemorrhages, 20 tuberculomas. The only statistically significant difference between the two groups was in the stroke occurrence, more frequent in the HIV+ group (P =.028), all involving the basal ganglia. Conclusions: Stroke involving the basal ganglia best differentiates CNSTB patients who are HIV+ from those HIV−. This finding was not correlated with meningeal enhancement suggesting that small arteries involvement might precede it. Therefore, we think that HIV+ patients with a new onset of stroke should be evaluated for CNSTB. Follow-up MRI should also be planned since meningeal enhancement might appear in later stages of the disease.
KW - HIV
KW - MRI
KW - Stroke
KW - Tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=85072575704&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85072575704&partnerID=8YFLogxK
U2 - 10.1016/j.neurad.2019.07.008
DO - 10.1016/j.neurad.2019.07.008
M3 - Article
C2 - 31539581
AN - SCOPUS:85072575704
SP - 1
EP - 18
JO - Journal of Neuroradiology
JF - Journal of Neuroradiology
SN - 0150-9861
ER -