PENYENGATAN MENINGEAL SISTERNA BASALIS MENINGITIS TB PADA COMPUTED TOMOGRAPHY SCANNING: SEBUAH ULASAN BERGAMBAR

A. Tjan, M. Asih, Elysanti Dwi Martadiani
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Abstract

Tuberculosis (TB) is one of the major worldwide threat and global burden in Indonesia. CNS tuberculosis is the most severe form of TB infection. CT evaluation on diagnosing tuberculosis meningitis (TBM) with triad of hydrocephalus, basal meningeal enhancement and infarction was reported to be sensitive. PCR cerebrospinal fluid (CSF) is known to be specific, however negative results have been reported due to presence of PCR’s inhibitors, poor lysis of mycobacteria, and the uneven distribution in specimens. CT Scan plays the vital role in diagnosing TBM patient with the presence of TBM CT triad, especially basal cistern enhancement (BME) which is the specific enhancement pattern in MTB patient. There are 9 must know BME pattern, such as contrast filling the cistern, double and triple line, linear enhancement at MCA cistern, Y sign, posterior infundibular recess enhancement, ill defined border, join the dots sign, nodular enhancement, and asymmetry off all pattern. Familiarizing BME criteria is essential to provide confident diagnosis and reduce morbidity and mortality
结核病(TB)是印度尼西亚的主要世界威胁和全球负担之一。中枢神经系统结核是最严重的结核感染形式。本文报道结核性脑膜炎(TBM)合并脑积水、基底膜增强和脑梗死三联征的CT诊断敏感性。已知PCR脑脊液(CSF)具有特异性,但由于PCR抑制剂的存在、分枝杆菌裂解不良以及标本分布不均匀,已报道阴性结果。CT扫描对TBM患者的诊断起着至关重要的作用,特别是基底池增强(BME)是MTB患者特有的增强模式。有9种必须知道的BME模式,如造影剂填充池、双线和三线、MCA池线状增强、Y征、基底窝后隐窝增强、边界不清、连点征、结节增强、不对称等。熟悉脑脊髓炎的标准对于提供可靠的诊断和降低发病率和死亡率至关重要
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