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A prospective study of magnetic resonance imaging patterns of central nervous system infections in pediatric age group and young adults and their clinico-biochemical correlation.
J Pediatr Neurosci. 2016 Jan-Mar; 11(1):46-51.JP

Abstract

BACKGROUND

Infections of the central nervous system (CNS) are common and routinely encountered. Our aim was to evaluate the neuroimaging features of the various infections of the CNS so as to differentiate them from tumoral, vascular, and other entities that warrant a different line of therapy.

AIMS

Our aim was to analyze the biochemical and magnetic resonance imaging (MRI) features in CNS infections.

SETTINGS AND DESIGN

This was a longitudinal, prospective study over a period of 1½ years.

SUBJECTS AND METHODS

We studied cerebrospinal fluid (CSF) findings and MRI patterns in 27 patients of 0-20 years age group with clinical features of CNS infections. MRI was performed on MAGNETOM Avanto 18 Channel 1.5 Tesla MR machine by Siemens India Ltd. The MRI protocol consisted of diffusion-weighted and apparent diffusion coefficient imaging, turbo spin echo T2-weighted, spin echo T1-weighted, fluid-attenuated inversion recovery (FLAIR), and gradient-echo in axial, FLAIR in coronal, and T2-weighted in sagittal plane. Contrast-enhanced T1-weighted sequence and MR spectroscopy were done whenever indicated.

RESULTS AND CONCLUSIONS

We found that most of the children belong to 1-10 years age group. Fungal infections were uncommon, mean CSF adenosine deaminase values specific for tuberculosis and mean CSF glucose-lowered in pyogenic. Hemorrhagic involvement of thalamus with/without basal ganglia and brainstem involvement may indicate Japanese encephalitis or dengue encephalitis. Diffusion restriction or hemorrhage in not expected in the brainstem afflicted lesions of rabies. Congenital cytomegalovirus can cause cortical malformations. T1 hyperintensities with diffusion restriction may represent viral encephalitis. Lesions of acute disseminated encephalomyelitis (ADEM) may mimic viral encephalitis. Leptomeningeal enhancement is predominant in pyogenic meningitis. Basilar meningitis in the presence of tuberculomas is highly sensitive and specific for tuberculosis.

Authors+Show Affiliations

Department of Radiodiagnosis, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.Department of Radiodiagnosis, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.Department of Radiodiagnosis, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.Department of Radiodiagnosis, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.Department of Dentistry, Baba Jaswant Singh Dental College, Ludhiana, Punjab, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27195033

Citation

Gupta, Kamini, et al. "A Prospective Study of Magnetic Resonance Imaging Patterns of Central Nervous System Infections in Pediatric Age Group and Young Adults and Their Clinico-biochemical Correlation." Journal of Pediatric Neurosciences, vol. 11, no. 1, 2016, pp. 46-51.
Gupta K, Banerjee A, Saggar K, et al. A prospective study of magnetic resonance imaging patterns of central nervous system infections in pediatric age group and young adults and their clinico-biochemical correlation. Journal of pediatric neurosciences. 2016;11(1):46-51.
Gupta, K., Banerjee, A., Saggar, K., Ahluwalia, A., & Saggar, K. (2016). A prospective study of magnetic resonance imaging patterns of central nervous system infections in pediatric age group and young adults and their clinico-biochemical correlation. Journal of Pediatric Neurosciences, 11(1), 46-51. https://doi.org/10.4103/1817-1745.181244
Gupta K, et al. A Prospective Study of Magnetic Resonance Imaging Patterns of Central Nervous System Infections in Pediatric Age Group and Young Adults and Their Clinico-biochemical Correlation. Journal of pediatric neurosciences. 2016 Jan-Mar;11(1):46-51. PubMed PMID: 27195033.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective study of magnetic resonance imaging patterns of central nervous system infections in pediatric age group and young adults and their clinico-biochemical correlation. AU - Gupta,Kamini, AU - Banerjee,Avik, AU - Saggar,Kavita, AU - Ahluwalia,Archana, AU - Saggar,Karan, PY - 2016/5/20/entrez PY - 2016/5/20/pubmed PY - 2016/5/20/medline KW - Encephalitis KW - hyperintense KW - magnetic resonance imaging KW - meningitis KW - pyogenic KW - tuberculosis SP - 46 EP - 51 JF - Journal of pediatric neurosciences VL - 11 IS - 1 N2 - BACKGROUND: Infections of the central nervous system (CNS) are common and routinely encountered. Our aim was to evaluate the neuroimaging features of the various infections of the CNS so as to differentiate them from tumoral, vascular, and other entities that warrant a different line of therapy. AIMS: Our aim was to analyze the biochemical and magnetic resonance imaging (MRI) features in CNS infections. SETTINGS AND DESIGN: This was a longitudinal, prospective study over a period of 1½ years. SUBJECTS AND METHODS: We studied cerebrospinal fluid (CSF) findings and MRI patterns in 27 patients of 0-20 years age group with clinical features of CNS infections. MRI was performed on MAGNETOM Avanto 18 Channel 1.5 Tesla MR machine by Siemens India Ltd. The MRI protocol consisted of diffusion-weighted and apparent diffusion coefficient imaging, turbo spin echo T2-weighted, spin echo T1-weighted, fluid-attenuated inversion recovery (FLAIR), and gradient-echo in axial, FLAIR in coronal, and T2-weighted in sagittal plane. Contrast-enhanced T1-weighted sequence and MR spectroscopy were done whenever indicated. RESULTS AND CONCLUSIONS: We found that most of the children belong to 1-10 years age group. Fungal infections were uncommon, mean CSF adenosine deaminase values specific for tuberculosis and mean CSF glucose-lowered in pyogenic. Hemorrhagic involvement of thalamus with/without basal ganglia and brainstem involvement may indicate Japanese encephalitis or dengue encephalitis. Diffusion restriction or hemorrhage in not expected in the brainstem afflicted lesions of rabies. Congenital cytomegalovirus can cause cortical malformations. T1 hyperintensities with diffusion restriction may represent viral encephalitis. Lesions of acute disseminated encephalomyelitis (ADEM) may mimic viral encephalitis. Leptomeningeal enhancement is predominant in pyogenic meningitis. Basilar meningitis in the presence of tuberculomas is highly sensitive and specific for tuberculosis. SN - 1817-1745 UR - https://www.unboundmedicine.com/medline/citation/27195033/A_prospective_study_of_magnetic_resonance_imaging_patterns_of_central_nervous_system_infections_in_pediatric_age_group_and_young_adults_and_their_clinico_biochemical_correlation_ L2 - http://www.pediatricneurosciences.com/article.asp?issn=1817-1745;year=2016;volume=11;issue=1;spage=46;epage=51;aulast=Gupta DB - PRIME DP - Unbound Medicine ER -
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