CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2021; 31(01): 030-036
DOI: 10.1055/s-0041-1729119
Original Article

Assessment of Blood–Brain Barrier Integrity in Tuberculous Meningitis Using Dynamic Contrast-Enhanced MR Perfusion

Shruti Kumar
1  Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
,
Paramjeet Singh
1  Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
,
Sameer Vyas
1  Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
,
Manish Modi
2  Department of Neurology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
,
Vivek Agarwal
1  Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
,
Manoj Kumar Goyal
2  Department of Neurology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
,
Naveen Sankhyan
3  Department of Pediatric Neurology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
› Institutsangaben

Abstract

Objective Tuberculous meningitis (TBM) is the most common form of central nervous system tuberculosis. The aim of the study was to quantitatively evaluate blood–brain barrier (BBB) perfusion changes in TBM patients using dynamic contrast-enhanced (DCE) MR perfusion.

Methods and Material Thirty untreated patients of TBM and 10 healthy controls were prospectively evaluated by conventional imaging and DCE MR perfusion. Mean permeability indices—Ktrans and Ve—were calculated from multiple regions of interest (ROIs) placed in basal cisterns and comparison was done between the patients and controls.

Results The permeability indices were significantly higher (where p < 0.001) in cisterns of TBM patients who showed basal meningeal enhancement when compared with healthy controls. Significant differences in permeability were observed between “enhancing” cases and controls as well as in “enhancing” cases when compared with the “non-enhancing” cases. However, no significant difference was observed in the mean cisternal value between “non-enhancing” cases and the controls. Ktrans with a cutoff value of > 0.0838 had 81.6% sensitivity and 78.6% specificity in differentiating cases and controls while Ve mean value with a cutoff value of 0.0703 showed 86.8% sensitivity and 91.4% specificity in predicting the permeability difference between the cases and controls.

Conclusion DCE MR perfusion is useful in the quantitative measurement of disruption of BBB and perfusion alterations in patients of TBM.



Publikationsverlauf

Publikationsdatum:
01. Juni 2021 (online)

© 2021. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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