Mathews V P, Kuharik M A, Edwards M K, D'Amour P G, Azzarelli B, Dreesen R G
Department of Radiology, University Hospital, Indianapolis, IN 46223.
AJR Am J Roentgenol. 1989 Jan;152(1):131-6. doi: 10.2214/ajr.152.1.131.
Gd-DTPA-enhanced MR images of experimental bacterial meningitis were obtained after Staphylococcus aureus was inoculated directly into the cisterna magna of four dogs. Each animal was studied with both unenhanced and enhanced MR and CT with Gd-DTPA and meglumine iothalamate, respectively. The enhancement patterns resulting from these techniques were compared and images were correlated with histopathology. All animals demonstrated abnormal leptomeningeal enhancement on MR with Gd-DTPA, but only one of four dogs exhibited abnormal contrast enhancement on CT. In these animals Gd-DTPA-enhanced MR also identified complications of meningitis, such as ventriculitis and cerebritis, more effectively than CT did. Unenhanced MR was not helpful in identifying meningitis. Histologic evaluation demonstrated that the abnormal areas of contrast enhancement on MR and CT correlated with inflammatory cell infiltration. However, some regions of mild leptomeningitis, ependymitis, and cerebritis identified histologically did not demonstrate abnormal enhancement. Since the animal model used was clinically and pathologically similar to human meningitis, we propose that Gd-DTPA-enhanced MR will subsequently be found more effective than unenhanced MR and IV contrast-enhanced CT for demonstrating meningitis and its complications in humans.
将金黄色葡萄球菌直接接种到四只犬的小脑延髓池后，获得了实验性细菌性脑膜炎的钆喷酸葡胺增强磁共振成像（MR）。每只动物分别接受了平扫和使用钆喷酸葡胺及碘他拉葡胺增强的MR和CT检查。对这些技术产生的强化模式进行了比较，并将图像与组织病理学结果进行了关联。所有动物在使用钆喷酸葡胺的MR检查中均显示软脑膜强化异常，但四只犬中只有一只在CT检查中显示对比剂强化异常。在这些动物中，钆喷酸葡胺增强MR比CT更有效地识别了脑膜炎的并发症，如脑室炎和脑实质炎。平扫MR对识别脑膜炎没有帮助。组织学评估表明，MR和CT上对比剂强化异常的区域与炎性细胞浸润相关。然而，组织学上确定的一些轻度软脑膜炎、室管膜炎和脑实质炎区域并未显示异常强化。由于所使用的动物模型在临床和病理上与人类脑膜炎相似，我们认为随后将发现钆喷酸葡胺增强MR在显示人类脑膜炎及其并发症方面比平扫MR和静脉对比剂增强CT更有效。
