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Arterial spin-labeling perfusion imaging of childhood meningitis: a case series
Alex Mun-Ching Wong1, Chih-Hua Yeh1, Ho-Ling Liu2
1Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Keelong, Linkou Medical Center and Chang Gung University, 5 Fu-Hsing Street, Tao Yuan, 333, Taiwan.
Introduction:
Conventional magnetic resonance imaging (MRI), which is mainly used to detect complications, is ineffective in determining the neurological status of patients with meningitis. Hemodynamic change in the brain may be more indicative of the neurological status but few imaging studies have verified this. Arterial spin-labeling (ASL) perfusion, a noninvasive MR method requiring no contrast agent injection, can be used to measure cerebral blood flow (CBF).
Case Reports:
We describe three pediatric patients with meningitis, who all showed regions of increased CBF on perfusion imaging. One patient, presenting with headache and conscious disturbance, had CBF changes in the frontal, temporal, and occipital regions. The other two patients, presenting with hallucinations, memory deficits, and seizures, had CBF changes in the frontal and temporal regions.
Conclusion:
ASL perfusion imaging may be helpful in assessing patients with meningitis, demonstrating CBF changes more strongly correlating with the neurological status, and detecting active brain abnormalities.
Insights
Arterial spin-labeling (ASL) perfusion imaging shows increased cerebral blood flow (CBF) in meningitis patients. This noninvasive technique may help assess neurological status and detect brain abnormalities.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Conventional magnetic resonance imaging (MRI) is limited in assessing neurological status in meningitis.
- Cerebral hemodynamic changes may better indicate neurological status, but require verification.
- Arterial spin-labeling (ASL) perfusion is a noninvasive MRI technique for measuring cerebral blood flow (CBF) without contrast agents.
Observation:
- Three pediatric meningitis patients were studied using ASL perfusion imaging.
- All patients exhibited regions of increased CBF.
- Neurological symptoms correlated with specific patterns of CBF changes in different brain regions.
Findings:
- ASL perfusion imaging revealed increased CBF in pediatric meningitis patients.
- Observed CBF changes corresponded with neurological deficits such as headache, conscious disturbance, hallucinations, memory deficits, and seizures.
- Specific patterns of increased CBF were noted in the frontal, temporal, and occipital regions.
Implications:
- ASL perfusion imaging shows promise for evaluating neurological status in meningitis.
- This technique may offer a more accurate assessment of brain abnormalities compared to conventional MRI.
- ASL can help detect active brain changes associated with meningitis, guiding clinical management.
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