Imaging Diagnosis of Spinal Intramedullary Tuberculoma: Case Reports and Literature Review

Background/Objective: Spinal intramedullary tuberculoma is rare, accounting for 2/100,000 of cases of tuberculosis and only 2% of all cases of tuberculosis of the central nervous system. Diagnostic imaging is essential to improving diagnosis and management of this disease. Methods: The clinical profile, radiological data, and histological slides of 2 cases of intramedullary tuberculomas confirmed by pathologic examinations were reviewed. Results: In 2 cases, magnetic resonance imaging (MRI) showed thickening of the spinal cord and oval lesions with a low T1-weighted image signal and a typical "target sign" T2-weighted image signal. After gadopentetate dimeglumine administration, the lesion's rim shape was enhanced, showing uneven wall thickness and sharp margins. Conclusions: MRI findings of spinal intramedullary tuberculoma were specific, and accurate diagnosis could be obtained. MRI is the optimal measure because it shows location, size, and number of lesions and the presence of degeneration and necrosis.