Abstract
Integrity of descending white matter tracts can be evaluated by diffusion tensor imaging.
In rim-enhancing intraparenchymal lesions, this technique can assist in the differentiation
of demyelinating disease from tumor or abscess. Diffusion tensor imaging characteristics
of tuberculoma have not been previously reported to our knowledge. A patient with
headaches, dizziness, and mild left-sided weakness underwent MRI with diffusion tensor
imaging. A large, rim-enhancing lesion within the pons was discovered, which subsequently
was diagnosed as tuberculoma. Tractography maps prepared from diffusion tensor imaging
data revealed predominantly displaced descending fiber tracts in the region of the
rim-enhancing lesion. A few tracts adjacent to the lesion appeared truncated, and
this abnormal finding correlated to the patient’s clinical deficit. The tractography
characteristics of diffusion tensor imaging in this patient potentially are distinct
from those seen with demyelinating lesions, which may show more extensive tract truncation.
Together with the consonance of exam findings and tract truncation seen in this patient,
tractography may prove useful in the diagnosis of suspected tuberculoma.
Keywords
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References
- Brainstem tuberculoma in the immunocompetent: case report and literature review.Clin Neurol Neurosurg. 2008; 110: 302-304
- Intracranial tuberculoma: is diffusion-weighted imaging useful in the diagnosis?.Eur Radiol. 2003; 13: 2049-2050
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Article info
Publication history
Accepted:
January 10,
2013
Received:
January 2,
2013
Identification
Copyright
© 2013 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
