Role of whole-body magnetic resonance imaging in the evaluation of extrapulmonary tuberculosis in immunocompetent patients

J Comput Assist Tomogr. 2014 May-Jun;38(3):415-23. doi: 10.1097/RCT.0000000000000065.

Abstract

Objective: The aim of this study was to evaluate the role of whole-body magnetic resonance imaging (WB-MRI) in imaging of extrapulmonary tuberculosis.

Methods: Eighteen patients with single-site extrapulmonary tuberculosis were evaluated with contrast-enhanced dedicated MRI of the clinically symptomatic site followed by WB-MRI using contrast-enhanced 3-dimensional (3D) modified DIXON technique (m-DIXON) and diffusion-weighted WB imaging with background body signal suppression (DWIBS) sequences. Studies were read by 2 experienced radiologists, and additional lesions seen on WB-MRI were separately charted.

Results: Of 18 patients, 14 were found to have asymptomatic involvement of other organs on WB-MRI. In 5 patients, the information was helpful in choosing an easily accessible site for biopsy/aspiration. Postcontrast 3D m-DIXON was better in picking up brain and lymph nodal lesions, whereas DWIBS was better in detecting vertebral lesions.

Conclusions: Whole-body MRI may be used for assessing the asymptomatic involvement of other body organs in tuberculosis. The combination of postcontrast 3D m-DIXON and DWIBS is complementary and may provide a road map for biopsy of accessible lesions.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Humans
  • Immunocompetence / immunology*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tuberculosis / immunology*
  • Tuberculosis / pathology*
  • Whole Body Imaging / methods*
  • Young Adult