Abstract
AIM: To compare the sensitivity and specificity of post contrast T1W sequence with post contrast FLAIR sequence of MRI brain for early detection of leptomeningitis. METHODS: A prospective comparative study was conducted for a period of 4 months. MRI brain examination was performed on 55 patients with suspicion of meningitis. Out of these, 48 patients were male and 7 were female. For those patients, contrast enhanced MRI brain with post contrast T1W sequence and post contrast FLAIR sequences were acquired. Then MRI findings were compared with CSF analysis results which was taken by lumbar puncture and considered as a “reference standard”. RESULTS: On CSF analysis of 55 patients, 43 patients were diagnosed positive as having meningitis and 12 patients were negative. Out of these 43 patients, post contrast FLAIR sequence was positive in 41 patients and 33 patients were positive on post contrast T1W sequence. In the finding of meningitis, post contrast FLAIR sequence sensitivity was 95.3% and specificity was 83.3%. While, post contrast T1W sequence sensitivity was 76.7% and 75% was specificity. CONCLUSION: The sensitivity and specificity of post contrast FLAIR sequence is more as compared to post contrast T1W sequence in the diagnosis of meningitis. In suspected cases of meningitis post contrast FLAIR sequence should be used as a routine sequence for the diagnosis of meningitis.
Highlights
Leptomeninges is the two innermost sheets of tissues that envelop the brain and spinal cord and formed by the layers of arachnoid and pia mater
Out of these 43 patients, post contrast Fluid-attenuated inversion recovery (FLAIR) sequence was positive in 41 patients and 33 patients were positive on post contrast T1W sequence
Study Design This study regarding the comparison of Post contrast FLAIR and T1 weighted magnetic resonance imaging (MRI) sequences results correlated with cerebrospinal fluid (CSF) analysis was a prospective comparative study
Summary
Leptomeninges is the two innermost sheets of tissues that envelop the brain and spinal cord and formed by the layers of arachnoid and pia mater. The arachnoid membrane lies on the dura that is thin and tough membrane at the level of the base of the brain. The brain and spinal cord surface is closely covered by pia mater membrane[1]. Meningitis can be life threatening in the world, if not suspected timely, properly diagnosed and managed[2]. Death can be occurred due to the delay in administration of antibiotic. A 4-6 hours delay in the administration of antibiotic can increase the risk of death 8.4 times[3]. Bacterial meningitis is the significant noticeable origin of morbidity in children under 5 years of age[4]
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