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Spectrum and Prevalence of Pathological Intracranial Magnetic Resonance Imaging Findings in Acute Bacterial

N Lummel1, M Koch2, M Klein3

  • 1Department of Neuroradiology, Klinikum Grosshadern, Ludwig-Maximilian-University, Marchioninistrasse 15, 81377, Munich, Germany. nina.lummel@med.uni-muenchen.de.

Clinical Neuroradiology
|September 24, 2014
PubMed
Abstract

Insights

Magnetic resonance imaging (MRI) frequently reveals pathological findings in acute bacterial meningitis. Streptococcal meningitis, particularly pneumococcal, is linked to more intraventricular diffusion restrictions, indicating pyogenic ventriculitis.

Area of Science:

  • Neurology
  • Radiology
  • Infectious Diseases

Background:

  • Acute bacterial meningitis is a serious infection with potential neurological complications.
  • Intracranial magnetic resonance imaging (MRI) plays a crucial role in diagnosing and assessing the extent of meningitis-related brain damage.

Purpose of the Study:

  • To determine the spectrum and prevalence of pathological intracranial MRI findings in patients diagnosed with acute bacterial meningitis.
  • To correlate specific MRI findings with causative bacterial agents.

Main Methods:

  • Retrospective analysis of patients with cerebrospinal fluid-proven bacterial meningitis between 2007 and 2012.
  • Evaluation of MRI scans by two neuroradiologists for pathological signal alterations, noting presence and location.
  • Identification of pathogenic agents and clinical symptoms.

Main Results:

  • Out of 75 patients with available MRI, 82.7% showed meningitis-associated pathological findings.
  • Intraventricular signal alterations (pyogenic ventriculitis) occurred in 54.7%, sulcal changes in 29.3%, and intraparenchymal changes in 20-26.7%.
  • Diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) sequences were most sensitive. Streptococcal meningitis cases showed significantly more intraventricular/sulcal diffusion restrictions (85.3%) compared to other agents (32.4%).

Conclusions:

  • Pathological MRI findings are common in acute bacterial meningitis.
  • Intraventricular diffusion restrictions, indicative of pyogenic ventriculitis, are more prevalent in streptococcal, especially pneumococcal, meningitis.
  • MRI is valuable for characterizing the spectrum of intracranial complications in bacterial meningitis.
Keywords:
Acute bacterial meningitisDWIFLAIRPneumococcal meningitisSulcalVentriculitis

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