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Infectious meningitis: prospective evaluation with magnetization transfer MRI

P Kamra1, R Azad, K N Prasad

  • 1Department of Radiology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India-226014.

The British Journal of Radiology
|May 4, 2004
PubMed

Insights

Magnetization transfer MRI effectively characterizes infectious meningitis. Meningeal visibility on pre-contrast T1-weighted MT images strongly suggests tuberculous meningitis, aiding diagnosis.

Area of Science:

  • Radiology
  • Neurology
  • Infectious Diseases

Background:

  • Infectious meningitis requires accurate etiological characterization for appropriate treatment.
  • Magnetization transfer (MT) MRI offers potential for detailed tissue characterization.

Purpose of the Study:

  • To prospectively evaluate MT MRI for characterizing infectious meningitis of various etiologies.
  • To assess the diagnostic utility of meningeal visibility and enhancement patterns on MT MRI.

Main Methods:

  • Prospective study of 100 patients with proven meningitis.
  • Acquisition of spin-echo T1, T2, and pre/post-contrast T1-weighted MT images.
  • Calculation of MT ratio (MTR) and signal intensity differences between meninges and brain parenchyma.

Main Results:

  • T1-weighted MT images demonstrated 96% sensitivity for detecting abnormal meningeal enhancement.
  • Meningeal visibility on pre-contrast T1-weighted MT images was specific to tuberculous meningitis.
  • Significantly higher MTR and signal intensity differences were observed in tuberculous meningitis compared to other etiologies.

Conclusions:

  • MT MRI is a valuable technique for detecting and differentiating infectious meningitis etiologies.
  • Pre-contrast meningeal visibility on T1-weighted MT images is a key indicator of tuberculous meningitis.

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