Absence of posterior pituitary bright spot in adults with CNS tuberculosis: A case-control study

Current diagnostic methods used in Central Nervous System Tuberculosis (CNS TB) are limited by the paucibacillary nature of this form of tuberculosis. Posterior pituitary bright spot (PPBS) refers to an area of T1 hyperintensity in the posterior pituitary in MR imaging of the brain. It is found in 8...

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Published in:PloS one 2022-10, Vol.17 (10), p.e0275460
Main Authors: G, Smitesh G, Mannam, Pavithra, Kumar, Vignesh, George, Tina, K, Murugabharathy, Prakash, Turaka Vijay, Yadav, Bijesh, Sudarsanam, Thambu David
Format: Article
Language:English
Subjects:
Adult
Adults
Biology and Life Sciences
Brain
Case-Control Studies
Central nervous system
Child
Children
Diagnosis
Diagnostic systems
Health aspects
Humans
Hydrocephalus
Likelihood ratio
Magnetic resonance imaging
Medical diagnosis
Medical examination
Medical imaging
Medical records
Medical schools
Medicine
Medicine and Health Sciences
Neuroimaging
People and Places
Physiological aspects
Pituitary (posterior)
Pituitary gland
Pituitary Gland, Posterior
Research and Analysis Methods
Retrospective Studies
Sensitivity
Sensitivity and Specificity
Tuberculosis
Tuberculosis - diagnosis
Tuberculosis, Central Nervous System - diagnostic imaging
Tuberculous meningitis
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creator G, Smitesh G
Mannam, Pavithra
Kumar, Vignesh
George, Tina
K, Murugabharathy
Prakash, Turaka Vijay
Yadav, Bijesh
Sudarsanam, Thambu David
description Current diagnostic methods used in Central Nervous System Tuberculosis (CNS TB) are limited by the paucibacillary nature of this form of tuberculosis. Posterior pituitary bright spot (PPBS) refers to an area of T1 hyperintensity in the posterior pituitary in MR imaging of the brain. It is found in 80-90% of healthy children and adults. In children with CNS TB, nearly half have absence of PPBS. This finding has not been described in adults. Our study looked for absence of PPBS in MR imaging and its association with CNS tuberculosis. To study prevalence of the absence of PPBS in patients with CNS tuberculosis when compared to a control group of normal patients. This was a retrospective case-control study of 100 patients with CNS tuberculosis and 200 controls (matched in 1:2 ratio) of patients with normal MRI brain. The MRI images were presented to a blinded radiologist in a randomised sequence to report for absence of PPBS. The data was subsequently analysed to look for association of absence of PPBS with CNS tuberculosis. Absence of PPBS (cases (47%), controls (8.5%)) was significantly associated with CNS tuberculosis in (Odds ratio-7.90, 95%CI 4.04-15.44, P-value
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Absence of PPBS (cases (47%), controls (8.5%)) was significantly associated with CNS tuberculosis in (Odds ratio-7.90, 95%CI 4.04-15.44, P-value&lt;0.0001). The specificity, sensitivity, positive predictive value and positive likelihood ratio are 91.5%, 47%, 73.4% and 5.53 respectively. Adding of absence of PPBS as an additional radiological feature in diagnosis of CNS TB increased the sensitivity from 77% to 84%. 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Absence of PPBS (cases (47%), controls (8.5%)) was significantly associated with CNS tuberculosis in (Odds ratio-7.90, 95%CI 4.04-15.44, P-value&lt;0.0001). The specificity, sensitivity, positive predictive value and positive likelihood ratio are 91.5%, 47%, 73.4% and 5.53 respectively. Adding of absence of PPBS as an additional radiological feature in diagnosis of CNS TB increased the sensitivity from 77% to 84%. Absence of PPBS is significantly associated with CNS tuberculosis and could be a relatively simple diagnostic aid in the diagnosis of CNS tuberculosis.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>36206275</pmid><doi>10.1371/journal.pone.0275460</doi><tpages>e0275460</tpages><orcidid>https://orcid.org/0000-0001-5978-7395</orcidid><orcidid>https://orcid.org/0000-0001-9117-1996</orcidid><oa>free_for_read</oa></addata></record>
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language eng
recordid cdi_plos_journals_2722687642
source Publicly Available Content (ProQuest); PubMed Central
subjects Adult
Adults
Biology and Life Sciences
Brain
Case-Control Studies
Central nervous system
Child
Children
Diagnosis
Diagnostic systems
Health aspects
Humans
Hydrocephalus
Likelihood ratio
Magnetic resonance imaging
Medical diagnosis
Medical examination
Medical imaging
Medical records
Medical schools
Medicine
Medicine and Health Sciences
Neuroimaging
People and Places
Physiological aspects
Pituitary (posterior)
Pituitary gland
Pituitary Gland, Posterior
Research and Analysis Methods
Retrospective Studies
Sensitivity
Sensitivity and Specificity
Tuberculosis
Tuberculosis - diagnosis
Tuberculosis, Central Nervous System - diagnostic imaging
Tuberculous meningitis
title Absence of posterior pituitary bright spot in adults with CNS tuberculosis: A case-control study
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