Multi-Slice Computed Tomography 5-Minute Delayed Scan is Superior to Immediate Scan after Contrast Media Application in Characterization of Intracranial Tuberculosis
Dailun Hou, Huifang Qu, Xu Zhang, Ning Li, Cheng Liu, Xiangxing Ma
Division of Computed Tomography, Department of Radiology, Shandong University School of Medicine, Thoracic Hospital, Shandong, China (mainland)
Med Sci Monit 2014; 20:1556-1562
The aim of this study was to determine whether the diagnosis of intracranial tuberculosis (TB) can be improved when multi-slice computed tomography (MSCT) scans are taken with a 5-min delay after contrast media application.
Material and Methods: Pre- and post-contrast CT scans of the head were obtained from 30 patients using a 16-slice spiral CT. Dual-phase acquisition was performed immediately and 5 min after contrast agent injection. Diagnostic values of different images were compared using a scoring system applied by 2 experienced radiologists.
Results: We found 526 lesions in 30 patients, including 22 meningeal thickenings, 235 meningeal tuberculomas/tubercles, and 269 parenchymal tuberculomas/tubercles. Images obtained with 5-min delayed scan time were superior in terms of lesion size and meningeal thickening outlining in all disease types (P<0.01). The ability to distinguish between vascular sections from the cerebral sulcus and tubercle was also improved (P<0.01).
Conclusions: Image acquisition with 5-min delay after contrast agent injection should be performed as a standard scanning protocol to diagnose intracranial TB.
Keywords: Child, Adult, Adolescent, Contrast Media - diagnostic use, Meninges - radiography, Multidetector Computed Tomography - methods, Time Factors, Tuberculoma, Intracranial - radiography, young adult