3/27/2023 0 Comments Csf fluid imageThe study was performed between 20 in a tertiary care hospital. Further, we investigated the utility of PCMRI as an alternate modality for identifying meningitis in patients in whom contrast is contraindicated and rapid diagnosis is required. In this study, we aimed to evaluate the pathophysiology of CSF flow alterations in meningitis and their related complications. There is a lack of sufficient literature on CSF dynamics in neuroinfectious conditions. Over the past few decades, clinical research has demonstrated associations among changes in CSF hydrodynamics with meningitis, hydrocephalus, and cerebral edema. CSF flow may be altered in many intracranial and intraspinal pathologies. This technique is non-invasive, highly sensitive even to slow flow and provides precise and reproducible measurement of quantitative parameters. Phase-contrast MRI (PCMRI) with cardiac synchronism is a dynamic technique used to visualize cerebrospinal fluid (CSF) movement. In addition, routine brain MRI imaging provides structural information but has a limited role in the assessment of CSF dynamics. Regardless of the advancements in magnetic resonance imaging (MRI), the optimal imaging protocol for diagnosing infectious meningitis remains contentious due to a lack of differentiation in enhancement in vessels and meninges on MRI and insufficient sensitivity in etiological characterization, primarily in the early stages. It also helps in evaluation of subsequent complications and therapeutic response monitoring. Neuroimaging has a crucial role in depiction of inflammatory changes in the brain and spine and may aid early diagnosis. Rapid diagnosis is essential to improve prognosis. Meningitis is a life-threatening infectious disease that causes inflammation in the brain and spinal cord membranes. This may aid in institution of appropriate clinical treatment. Conclusion:Īlteration of CSF flow dynamics on PCMRI can improve segregation of patients into viral and non- viral etiologies, especially in those in whom contrast is contraindicated or not recommended. At a cutoff value of 3.57 cm/s in peak CSF velocity, the specificity was 100% and sensitivity was 22.7% to differentiate between viral and non-viral meningitis. Viral meningitis showed milder alteration of CSF flow dynamics as compared to bacterial and tuberculous etiologies. A significant difference in peak velocity and stroke volume was noted in Group II as compared to controls. A wide variation of flow parameters was noted in meningitis irrespective of the degree of ventricular dilatation. The mean peak velocity and stroke volume in controls were 2.49 ± 0.86 cm/s and 13.23 ± 6.84 µl and in patients were 2.85 ± 2.90 cm/s and 16.30 ± 20.02 µl, respectively. Patients were subdivided into Group I (patients with hydrocephalus ) and Group II (patients without hydrocephalus ). Velocity encoding (Venc) was kept at 20 cm/s. Quantitative CSF analysis was performed at the level of cerebral aqueduct using cardiac-gated PCMRI. Materials and Methods:įifty patients with clinically confirmed or strongly suspected infectious meningitis and 20 controls were evaluated with MRI. The objective of the study was to evaluate the cerebrospinal fluid (CSF) flow alterations in meningitis using phase-contrast magnetic resonance imaging (PCMRI).
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |