Imaging of CNS Infections with Clinico-pathological Correlation
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Date
2019-05
Journal Title
Journal ISSN
Volume Title
Publisher
International Society for Contemporary Medical Research
Abstract
Introduction: CNS infections are an emerging health problemwith poor prognosis if the treatment is not prompt andadequate. Thus, establishing a correct diagnosis is necessaryto quickly start the appropriate treatment. This study wasundertaken to study the etiology and the imaging spectrum ofCNSI in and around western Uttar Pradesh in a tertiary healthcare set up and to correlate the neuro-imaging findings withclinic-pathological data.Material and Methods: In this Prospective Observationalstudy 80 patients clinically suspected of CNS infection werestudied by CT/MRI and the neuro imaging findings werecorrelated with clinical and CSF findings.Results: Based on clinical features, CSF findings, thetreatment given and the response to treatment tuberculousinfection (TBM) was most common infection (41.2%)followed by pyogenic meningitis (36.2%) and viral infection(22.5%). In 29 patients of pyogenic CNS infection mostcommon imaging finding was leptomeningitis(62%)followed by pachymeningitis (31%), hydrocephalus (24.1%),abscess (6.8%), post vasculitic infarct(6.8%) and extra axialcollection(6.8%). In 33 patients of tubercular CNS infectionmost common imaging finding was basal leptomeningitis(78.7%) followed by tuberculoma (72.7%), pachymeningitis(33.3%), hydrocephalus (27.2%), abscess (12.1%), postvasculitis infarct (12.1%) and spinal cord involvement in1 (3%) patient. In the 18 viral CNS infection cases mostcommon imaging finding was parenchymal hyperintensity onMRI or hypodensity on CT with/without peripheral vasogenicedema (94.4%) followed by leptomeningeal/pachymeningealinvolvement (61.1%) and post vasculitis infarct (11.1%).Conclusion: The sensitivity of neuroimaging in pyogenicCNS infection was 81.2% and specificity was 93.7% whilesensitivity of neuroimaging in tubercular CNS infection was88.8% and specificity was 97.8% and in viral CNS infectionsensitivity was 84.2% and specificity was 96.7%. There wassignificant association (p value <0.05) of basal leptomeningitisand granulomas on imaging with tubercular infection andparenchymal signal changes with viral infections
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Keywords
Imaging, CNS Infections, Clinico-pathological Correlation
Citation
Ojha Mandavee, Verma Sameer R., Saran Sonal, Mital Mukta, Bansal Pradeep. Role of Magnetic Resonance Cholangiopancreatography (MRCP) in the Evaluation of Patients with Obstructive Jaundice. International Journal of Contemporary Medical Research . 2019 May; 6(5): e6-e10