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MR Spectroscopy and Tuberculoma

Tuberculoma of the brain is an important clinical entity. The main challenge in the management of brain tuberculoma is its diagnosis. Appearance in cross sectional imaging of brain is common and consists of solitary or multiple ring-enhancing lesions with moderate perilesional edema, but these are not specific for tuberculoma as neurocysticercosis (NCC), coccidiomycosis, toxoplasmosis, metastasis and few other diseases may also have similar appearance

  • Magnetic resonance spectroscopy is of great value in the diagnosis of tuberculoma in cases of ring-enhancing lesions on CT scan or MRI imaging. It demonstrates a very high lipid peak, reduction in NAA and creatinine and a choline/creatinine ratio of >1. 
  • Lipid peak in MRS in the context of a ring-enhancing lesion is very much specific for tuberculoma and has not been seen in any cases of NCC, the other common differential diagnosis of a ring-enhancing lesion

MR Spectroscopy and Tuberculoma Reviewed by Sumer Sethi on Monday, January 25, 2016 Rating: 5

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