Lee Jeong Sub, Park Ji Kang, Kim Seung Hyoung, Jeong Sun Young, Kim Bong Soo, Choi Gukmyoung, Lee Mu Suk, Ko Su Yeon, Hwang Im-Kyung
Department of Radiology, Jeju National University School of Medicine, Jeju National University Hospital, 1753-3, Ara-1-dong, Jeju, Jeju Province, 690-716, Korea.
J Neurol. 2014 Apr;261(4):817-22. doi: 10.1007/s00415-014-7268-0. Epub 2014 Feb 26.
The aim of this study was to evaluate whether contrast enhanced fluid attenuated inversion recovery (CE-FLAIR) imaging can be used to predict the severity of meningitis based on leptomeningeal enhancement (LE) score and cerebrospinal fluid signal intensity (CSF-SI) on CE-FLAIR. We retrospectively analyzed data collected from 43 consecutive patients admitted to our hospital due to meningitis. Clinical factors including initial Glasgow Coma Scale (GCS) score, CSF glucose ratio, log CSF protein, log CSF WBC, and prognosis were evaluated. The LE score was semi-quantitatively scored, and we evaluated CSF-SI ratio at the interpeduncular or quadrigerminal cisterns on CE-FLAIR. We evaluated the differences in clinical variables, LE scores and CSF-SI ratios between the recovery and the complication group. We assessed the correlation between clinical variables, LE scores and CSF-SI ratios. The values of log CSF protein, CSF-SI ratio, and LE score were significantly higher in the complication group (p value <0.05). GCS score and CSF glucose ratio were significantly lower in the complication group (p value <0.01). The LE scores had significant negative correlation with GCS scores and CSF glucose ratios (p value <0.001). The LE score was significantly positively correlated with the value of log CSF protein and CSF-SI ratio (p value <0.01). The CSF-SI ratio was negatively correlated with GCS score and CSF glucose ratio (p value <0.01). The CSF-SI ratio was positively correlated with the value of log CSF protein (p value <0.05). Our results suggest that LE score and CSF-SI ratio are well correlated with clinical prognostic factors. We may predict the clinical severity of meningitis by using LE scores and CSF-SI ration on CE-FLAIR imaging.
本研究的目的是评估对比增强液体衰减反转恢复（CE-FLAIR）成像是否可用于基于软脑膜强化（LE）评分和CE-FLAIR上的脑脊液信号强度（CSF-SI）来预测脑膜炎的严重程度。我们回顾性分析了因脑膜炎连续入住我院的43例患者的数据。评估了包括初始格拉斯哥昏迷量表（GCS）评分、脑脊液葡萄糖比值、脑脊液蛋白对数、脑脊液白细胞对数和预后等临床因素。对LE评分进行半定量评分，并在CE-FLAIR上评估脚间池或四叠体池的CSF-SI比值。我们评估了恢复组和并发症组之间临床变量、LE评分和CSF-SI比值的差异。我们评估了临床变量、LE评分和CSF-SI比值之间的相关性。并发症组中脑脊液蛋白对数、CSF-SI比值和LE评分的值显著更高（p值<0.05）。并发症组的GCS评分和脑脊液葡萄糖比值显著更低（p值<0.01）。LE评分与GCS评分和脑脊液葡萄糖比值呈显著负相关（p值<0.001）。LE评分与脑脊液蛋白对数和CSF-SI比值的值呈显著正相关（p值<0.01）。CSF-SI比值与GCS评分和脑脊液葡萄糖比值呈负相关（p值<0.01）。CSF-SI比值与脑脊液蛋白对数的值呈正相关（p值<0.05）。我们的结果表明，LE评分和CSF-SI比值与临床预后因素密切相关。我们可以通过使用CE-FLAIR成像上的LE评分和CSF-SI比值来预测脑膜炎的临床严重程度。
