Estimation of role of CT scan and MRI in diagnosis of tuberculosis of brain and spine

Background: Tuberculosis of the brain and spine is a very severe disease and causes increased rate of mortality and morbidity. Its diagnosis is a challenge for physicians worldwide. Patients of different age groups and having varied socio-economic status suffer from neurotuberculosis which need to be evaluated successfully to help the physician with further management of the condition. Aim: To estimate role of CT scan and MRI in diagnosis of tuberculosis of brain and spine. Material and methods: Patients referred to the Radiology Department with any kind of neurological symptoms, coincidental finding of neurotuberculosis or even those with already diagnosed cases of neurotuberculosis which needed follow up radiological investigations were evaluated with either CT or MRI or sometimes both (These were performed on 1.5 T Philips MRI and Seimens 16 Slice MDCT machine). Results: Patients with intracranial tuberculosis mainly presented with tuberculous meningitis and tuberculomas. Most patients suffering from spinal infection presented with Pott’s spine. Most of the lesions were paradiscal with involvement of the articular discs. MRI is more sensitive than CT scan in the diagnosis of intracranial tuberculosis. MRI is also very sensitive in the diagnosis of spinal tuberculosis. However, CT plays no role in the diagnosis of spinal tuberculosis. Conclusion: There is a wide spectrum of manifestations associated with intracranial and spinal tuberculosis. Tuberculous meningitis and Pott’s spine were the commonest manifestations of intracranial and spinal tuberculosis respectively. MRI was more sensitive in the diagnosis of intracranial tuberculosis as compared to CT. CT had no significant role in the diagnosis of Spinal tuberculosis. Hence, MRI is the preferred choice of investigation while evaluating neurotuberculosis.