Abstract: Objective To explore the MRI imaging features of intracranial tuberculosis,including the anatomic location and pathological changes, and the patterns of MRI imaging changes during antituberculosis chemotherapy. Methods The clinical and MRI data of 255 cases with intracranial tuberculosis diagnosed in Guangzhou Chest Hospital from November 2017 to November 2019 was analyzed retrospectively for exploring the MRI features. Furthermore,the changes of MRI imaging during antituberculosis chemotherapy of 218 cases, of which treatment courses were normative and treatment records were complete,were collected for analyzing the MRI imaging change patterns.Results Firstly, there are 255 patients with intracranial tuberculosis including 70 cases of meningeal type, 77 cases of parenchymal type and 108 cases of mixed type, accounted for 27.45%, 30.20% and 42.35% respectively. Their pathological MRI included meningeal thickening, nodules of brain parenchymal tuberculosis, cerebral parenchymal tuberculosis,meningeal nodules, meningeal tuberculoma,tuberculous encephalitis and tuberculous abscess. Their number and percentage were 161, 143, 73, 54, 46, 18, 5 and 63.14%、56.07%、28.63%、21.18%、18.04%、7.06%, 1.96% respectively. Especially, 23 cases of tuberculoma, including 13 cases located at meninges and 10 cases located at brain parenchyma, presented cluster.Secondly, of the 218 cases observed during antituberculosis chemotherapy, MRI imaging of 116 cured patients presented “deterioration” signs during the 1 to 3 months of antituberculosis chemotherapy course, such as enlarged primary lesions, increased or new lesions.After 12 months and 18 months of treatment,the disappearance rates of MRI imaging of corresponding lesions(including brain parenchymal tuberculosis nodule, meningeal thickening, brain parenchymal tuberculosis, meningeal tuberculosis nodule, meningeal tuberculosis, parenchymal tuberculous abscess, meningeal or brain parenchymal tuberculosisandbrain parenchymal tuberculous encephalitis) were 89.58%, 77.03%, 75.00%, 67.74%, 37.04%, 20.00%, 0, 0 and 95.83%, 82.43%, 85.00%, 85.19%, 55.56%, 20.00%, 0, 0 respectively. Conclusion Various parts of the meninges and brain parenchyma may be involved with intracranial tuberculosis . The MRI imaging presents mainly meningeal thickening, tuberculous nodules, and tuberculomas,and most of the pathological MRI imaging can disappear after antituberculosis chemotherapy for these cases.But,the vast majority of the pathological MRI imaging after antituberculosis chemotherapy have not improved much for cases such as brain parenchymal tuberculous abscess, meningeal or brain parenchymal tuberculosis and brain parenchymal tuberculous encephalitis.It is suggested that comprehensive treatment involving multidisciplinary must be considered at the beginning of treatment for these cases.

Key words: Intracranial tuberculosis, Magnetic resonance imaging, Serial dynamic MRI findings