Abstract:

Objective: To describe MRI characteristics of spinal tuberculous meningitis, the changes after anti-tuberculosis treatment and the prognosis of patients. Methods: Using the electronic medical record management system of Beijing Chest Hospital Affiliated to Capital Medical University and Picture Archiving and Communication System (PACS), 31 patients whose complete MRI data were maintained and diagnosed as tuberculous spinal meningitis from 2012 to 2016 were selected as study objects. Two radiologists reviewed MRI retrospectively and the changes of spinal meninges, subarachnoid space and spinal cord were recorded. Results: The MRI showed that 96.8% (30/31) patients had thickened and enhanced meninges, 48.4% (15/31) had irregular or narrow subarachnoid space, 12.9% (4/31) had obliteration of the subarachnoid space, and 6.5% (2/31) had intradural extramedullary tuberculomas. Myelitis was detected in 51.6% (16/31) patients, while intramedullary tuberculoma was detected in 9.7% (3/31) patients. Furthermore, 58.3% (7/12) patients showed remission in the follow-up MRI, 25.0% (3/12) patients had progression; and 16.7% (2/12) patients showed no change in MRI. 71.0% patients (22/31) had a poor prognosis, including 13 deaths and 9 disability cases. Conclusion: Enhanced MRI can show the thickened and enhanced meninges, change in the subarachnoid space and in the spinal cord. MRI can also reflect the changes after anti-tuberculosis treatment. Enhanced MRI should be the first choice of imaging examination for patients with tuberculous spinal meningitis.

Key words: Tuberculosis,meningeal, Pia mater, Magnetic resonance imaging