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Cerebrospinal fluid analysis is associated with enhancement on MRI in bacterial and tuberculous meningitis: A
Ryoji Goto1, Yurino Horiuchi1, Haruka Kawakami1
1Department of Neurology, Center Hospital of the National Center for Global Health and Medicine, 21-1 Toyama Shinjuku-ku, Tokyo, Japan; Department of Neurology, Kohnodai Hospital of the National Center for Global Health and Medicine, 1-7-1 Kohnodai, Ichikawa, Chiba, Japan.
Objective:
Along with cerebrospinal fluid (CSF) analysis, enhancement on contrast-enhanced MRI is useful to diagnose meningitis. However, the conditions for its appearance have not been clarified. This study aimed to investigate the association between CSF parameters and enhancement on contrast-enhanced head or spinal MRI in patients with bacterial meningitis (BM) or tuberculous meningitis (TM).
Methods:
A total of 12 patients with BM and 23 patients with TM who underwent both CSF analysis and contrast-enhanced MRI were included. The correlation between CSF analysis and MRI findings has been examined using receiver operating characteristic (ROC) analysis.
Results:
Contrast enhancement was found in 7 and 10 patients with BM and TM, respectively. Both CSF analysis and MRI were useful to distinct between BM and TM, and the enhancement implied the severity of them. In patients with BM, higher CSF protein and lower CSF glucose were associated with enhancement on MRI, while not only CSF protein and glucose but also leukocyte and lymphocyte counts were associated with it in TM. CSF adenosine deaminase (ADA) did not show discriminant ability of the MRI findings.
Conclusions:
CSF analysis is associated with enhancement on contrast-enhanced MRI both in BM and TM. Our findings indicate the importance of CSF analysis in assessing the need to perform contrast-enhanced MRI, which may be useful in diagnosis, distinction, and estimation of prognosis in those patients.
Insights
Cerebrospinal fluid (CSF) analysis correlates with contrast-enhanced MRI findings in bacterial meningitis (BM) and tuberculous meningitis (TM). This association helps assess the need for MRI, aiding diagnosis and prognosis.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Contrast-enhanced MRI and cerebrospinal fluid (CSF) analysis are vital for diagnosing meningitis.
- The specific conditions influencing contrast enhancement in meningitis MRI require further clarification.
Purpose of the Study:
- To investigate the relationship between CSF parameters and contrast-enhanced MRI findings in bacterial meningitis (BM) and tuberculous meningitis (TM).
Main Methods:
- A study included 12 BM and 23 TM patients who underwent both CSF analysis and contrast-enhanced MRI.
- Receiver operating characteristic (ROC) analysis was used to examine the correlation between CSF analysis and MRI findings.
Main Results:
- Contrast enhancement was observed in 7 BM and 10 TM patients.
- Higher CSF protein and lower CSF glucose correlated with MRI enhancement in BM.
- In TM, CSF protein, glucose, leukocyte, and lymphocyte counts were associated with enhancement; CSF adenosine deaminase (ADA) showed no discriminatory ability.
Conclusions:
- CSF analysis is linked to contrast-enhanced MRI findings in both BM and TM.
- Findings highlight the importance of CSF analysis in determining the necessity of contrast-enhanced MRI for diagnosis, differentiation, and prognosis estimation.
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