MR angiography abnormality in patients with tuberculous meningitis: correlation factor and prognostic significance analyses

Abstract

Objective To evaluate the related factors of magnetic resonance angiography (MRA) abnormality and its prognostic value in patients with tuberculous meningitis (TBM). Methods One hundred and three TBM patients, admitted to our hospital from January 2007 to November 2014, were chosen in our study; their clinical data, laboratory examinations, MRA data and prognoses 6 months after onset were collected; Logistic regression analysis was performed to analyze the related factors of MRA abnormality, and the influence of these factors in prognosis of TBM was investigated. Results MRA was abnormal in 45 patients (43.7%). Logistic regression analysis indicated that age (older than 50 years), focal weakness, hydrocephalus and basal exudates were the related factors of MRA abnormality (OR=7.034, 95%CI: 1.797-27.536, P=0.005; OR=10.728, 95%CI: 2.042-56.359, P=0.005; OR=15.007, 95%CI: 2.572-87.577, P=0.003; OR=4.001, 95%CI: 1.139-14.056, P=0.031). In 37 patients with infarction in MR imaging, 29 had MRA abnormality at admission; in 27 patients having paradoxical reaction of antitubercular agents, 17 had MRA abnormality at admission; in 9 patients with poor prognosis, 7 had MRA abnormality at admission. Conclusion MRA abnormality is common in TBMpatients and it is associated with infarction, paradoxical reaction of antitubercular agents and poor outcomes; patients having elder age, focal weakness as well as hydrocephalus and basal exudates on MR imaging are trended to have MRA abnormality. Key words: Tuberculous Meningitis; Infarction; Vasculitis; Magnetic resonance angiography