Non-invasive diagnosis of lung tuberculosis in children by single voxel 1H-magnetic resonance spectroscopy

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• 作者：Ky Santy (1) (2)
  Phang Nan (1)
  Yay Chantana (1)
  Denis Laurent (3)
  Ianina Scheer (4)
  Beat Steinmann (5)
  David Nadal (6)
  Beat Richner (1)
  
• 关键词：Pulmonary lesions ; Diagnosis ; Magnetic resonance imaging ; Lipid ; 1H ; magnetic resonance spectroscopy ; Tuberculosis ; Resource ; poor country
• 刊名：European Journal of Pediatrics
• 出版年：2012
• 出版时间：August 2012
• 年：2012
• 卷：171
• 期：8
• 页码：1257-1263
• 全文大小：624KB
• 参考文献：1. Chang L, Ernst T (1997) MR spectroscopy and diffusion-weighted MR imaging in focal brain lesions in AIDS. Neuroimaging Clin N Am 7:409鈥?26
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• 作者单位：Ky Santy (1) (2)
  Phang Nan (1)
  Yay Chantana (1)
  Denis Laurent (3)
  Ianina Scheer (4)
  Beat Steinmann (5)
  David Nadal (6)
  Beat Richner (1)
  
  1. Division of Pediatrics, Jayavarman VII Hospital, Kantha Bopha Children鈥檚 Hospital, Siem Reap, Cambodia
  2. Division of Pediatric Imaging, Jayavarman VII Hospital, Kantha Bopha Children鈥檚 Hospital, Siem Reap, Cambodia
  3. Division of Pediatric Laboratory Medicine and Microbiology, Jayavarman VII Hospital, Kantha Bopha Children鈥檚 Hospital, Siem Reap, Cambodia
  4. Division of Imaging, University Children鈥檚 Hospital of Zurich, Zurich, Switzerland
  5. Division of Metabolism, University Children鈥檚 Hospital of Zurich, Zurich, Switzerland
  6. Division of Infectious Diseases and Hospital Epidemiology, and Children鈥檚 Research Center (CRC), University Children鈥檚 Hospital of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
  

文摘

Our previous study showed that 1H-magnetic resonance spectroscopy (1H-MRS) can detect lipid peaks characteristic for Mycobacterium tuberculosis infection in cerebral lesions of young children; therefore, we aimed to extend and validate the application of 1H-MRS for the diagnosis of active pulmonary tuberculosis lesions in three adolescent patients. Here, we document lipid peaks characteristic for M. tuberculosis infection by 1H-MRS from lung tissue surrounding lung cavities of two patients whose sputum samples were positive for acid-fast bacilli by microscopy and positive for M. tuberculosis by genetic testing, indicating active tuberculosis. A similar lipid peak was found also in the pleural effusion of a third patient with concurrent lung cavity compatible with active tuberculosis. However, in a patient with a pyogenic pulmonary abscess, 1H-MRS of the drained pus displayed different characteristic peaks but no lipid peak at all. Conclusion: Our findings further validate 1H-MRS as a rapid, non-invasive, and specific diagnostic tool for active tuberculosis in children with microbiologically documented infection outside the central nervous system, specifically in the lungs.