Differential diagnosis between cerebral tuberculosis and neurocysticercosis by magnetic resonance spectroscopy

J Comput Assist Tomogr. Jan-Feb 2005;29(1):112-4. doi: 10.1097/01.rct.0000149959.63294.8f.

Abstract

Single enhancing brain lesions (SELs), mostly as a result of neurocysticercosis or tuberculosis, are a common cause of seizures. Ten patients with SELs caused by neurocysticercosis (n=6) or tuberculosis (n=4) were examined by proton magnetic resonance spectroscopy. Tuberculomas had a high peak of lipids, more choline, and less N-acetylaspartate and creatine. The choline/creatine ratio was greater than 1 in all tuberculomas but in none of the cysticerci. Magnetic resonance spectroscopy differentiates SELs caused by cysticercosis or tuberculosis and may avoid brain biopsies or unnecessary antituberculosis treatments.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aspartic Acid / analogs & derivatives*
  • Aspartic Acid / analysis
  • Brain Diseases / diagnosis
  • Brain Diseases / parasitology*
  • Choline / analysis
  • Creatine / analysis
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Humans
  • Lactic Acid / analysis
  • Lipids / analysis
  • Magnetic Resonance Spectroscopy*
  • Male
  • Neurocysticercosis / diagnosis*
  • Neurocysticercosis / metabolism
  • Tuberculoma / diagnosis
  • Tuberculosis, Central Nervous System / diagnosis*
  • Tuberculosis, Central Nervous System / metabolism

Substances

  • Lipids
  • Aspartic Acid
  • Lactic Acid
  • N-acetylaspartate
  • Creatine
  • Choline