Diffusion-weighted MR imaging in intracranial infections

C C Lim1, W Lee, S M Chng

  • 1Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433. tchoyoson_lim@notes.ttsh.gov.sg

Abstract

Insights

Diffusion-weighted MRI (DWMRI) aids in diagnosing intracranial infections by showing distinct lesion appearances. This technique enhances lesion visibility, proving valuable for assessing central nervous system infections.

Area of Science:

  • Neurology
  • Radiology
  • Infectious Diseases

Background:

  • Diffusion-weighted magnetic resonance (MR) imaging (DWMRI) is a valuable tool for assessing acute cerebral infarction.
  • Its utility extends to other central nervous system (CNS) diseases, including intracranial infections.

Purpose of the Study:

  • To present the DWMRI appearance of various intracranial infections.
  • To evaluate DWMRI's effectiveness in lesion conspicuity and assessment of CNS infections.

Main Methods:

  • Reviewed 30 patients with clinically diagnosed CNS infections.
  • All patients underwent conventional contrast-enhanced MR and DWMRI (b = 1000 s/mm2) using single-shot echo-planar imaging.

Main Results:

  • Intracranial infections like abscesses and tuberculomas appeared hyperintense on DWMRI.
  • Neurocysticercosis lesions were hypointense, while encephalitis and toxoplasmosis showed variable DWMRI signal intensities.
  • Meningitis without parenchymal involvement was not detected by DWMRI, though one case of tuberculous meningitis showed infarction.

Conclusions:

  • DWMRI enhances lesion conspicuity in cerebral infections.
  • Distinct DWMRI appearances were observed for different infectious organisms and diseases, aiding in diagnosis.