Magnetic resonance imaging features of intraspinal tuberculosis in children

Objective To investigate the features of magnetic resonance imaging (MRI) of intraspinal tuberculoma in children. Methods The clinical and MRI data of 22 child patients with intraspinal tuberculoma confirmed by surgical pathology or by clinical follow-up in our department during 2008 and 2021 were collected and retrospectively reviewed. According to the location of tumor, they were divided into intramedullary (n=5), intradural extramedullary (n=8) and epidural tuberculoma (n=9) groups. The lesion shapes, signal and enhancement patterns were analyzed. Results Intramedullary tuberculoma had a round or round-like shape, while extramedullary tuberculoma presented as long-fusiform or en plaque shapes. Both intramedullary tuberculoma and extramedullary tuberculoma were mainly isointense (15/22) on T1-weighted images (T1WI) and hypointense (11/22) or isointense (7/22) on T2WI. Rim enhancement (5/5) was observed in intramedullary tuberculoma, and remarkable homogeneous enhancement (13/17) was dominant in extramedullary tuberculoma. The intraspinal tuberculomas occurred during anti-tuberculosis therapy in 10 cases, including 7 cases (7/8) of intradural extramedullary tuberculomas, with a significantly higher rate than epidural tuberculoma (2/9) or intramedullary tuberculoma (1/5). Conclusion MRI of intraspinal tuberculoma is characterized by isointense on T1WI, hypointense/isointense on T2WI, and rim or remarkable homogeneous enhancement. The occurrence of intraspinal tuberculoma should be vigilant during anti-tuberculosis treatment. Timely MRI examination is beneficial to early detection of intraspinal lesions.