Vaswani Aneel Kumar, Nizamani Waseem Mehmood, Ali Muhammad, Aneel Geeta, Shahani Bhesham Kumar, Hussain Sajjad
Dr. Ziauddin Hospital, Block 6, Scheme 5, Clifton, Karachi 74700, Pakistan.
Dr. Ziauddin Hospital, Block B, North Nazimabad, Karachi 74700, Pakistan.
ISRN Radiol. 2014 Mar 20;2014:578986. doi: 10.1155/2014/578986. eCollection 2014.
Purpose. To determine the diagnostic accuracy of contrast enhanced FLAIR sequence of MRI brain in the diagnosis of meningitis. Subjects and Methods. A prospective study of 57 patients with signs and symptoms of meningitis, referred to the radiology department for MRI examination. Out of these, there were 30 males and 27 females. They underwent MRI brain with contrast including postcontrast T1W and FLAIR sequences. Cerebrospinal fluid (CSF) analysis obtained by lumbar puncture after MRI was considered the "reference standard" against which MRI findings were compared. Results. Of 57 patients, 50 were diagnosed as having meningitis on subsequent CSF analysis. Out of these 50, 49 were positive on postcontrast FLAIR images and 34 were positive on postcontrast T1W images. One patient was labeled false positive as CSF analysis showed malignant cells (leptomeningeal carcinomatosis). In the diagnosis of meningitis, the sensitivity of postcontrast FLAIR sequence was 96% and specificity 85.71%, whereas the sensitivity of postcontrast T1W sequence was 68% and specificity 85.71%. Conclusion. Contrast-enhanced FLAIR sequence is more sensitive and specific than contrast-enhanced T1W sequence in the diagnosis of meningitis. It should be routinely used in suspected cases of meningitis.
目的。确定MRI脑部对比增强FLAIR序列在脑膜炎诊断中的诊断准确性。对象与方法。对57例有脑膜炎体征和症状并转诊至放射科进行MRI检查的患者进行前瞻性研究。其中，男性30例，女性27例。他们接受了包括对比剂增强T1W和FLAIR序列在内的脑部MRI检查。MRI检查后通过腰椎穿刺获得的脑脊液（CSF）分析被视为与MRI检查结果进行比较的“参考标准”。结果。在57例患者中，后续脑脊液分析显示50例被诊断为脑膜炎。在这50例中，49例在对比剂增强FLAIR图像上呈阳性，34例在对比剂增强T1W图像上呈阳性。1例患者被标记为假阳性，因为脑脊液分析显示有恶性细胞（软脑膜癌病）。在脑膜炎诊断中，对比剂增强FLAIR序列的敏感性为96%，特异性为85.71%，而对比剂增强T1W序列的敏感性为68%，特异性为85.71%。结论。对比剂增强FLAIR序列在脑膜炎诊断中比对比剂增强T1W序列更敏感、更具特异性。在疑似脑膜炎病例中应常规使用。
