• Neuroradiology · Aug 2005

    Clinical Trial

    Contrast-enhanced FLAIR in the early diagnosis of infectious meningitis.

    • Alesssandra Splendiani, Edoardo Puglielli, Rosanna De Amicis, Stefano Necozione, Carlo Masciocchi, and Massimo Gallucci.
    • Department of Radiology, University of L'Aquila, Ospedale S. Salvatore-Coppito, 67100 L'Aquila, Italy. istradiolaq@cc.univaq.it
    • Neuroradiology. 2005 Aug 1; 47 (8): 591-8.

    AbstractWe investigated the accuracy of MRI in the early diagnosis of infectious meningitis with emphasis on the value of gadolinium-enhanced fluid-attenuated inversion recovery (FLAIR) sequence. Twenty-seven patients with clinical suspicion of infectious meningitis were included. MRI was performed within 3 h of clinical evaluation. For all patients, T1-weighted spin-echo, dual-echo T2-weighted fast-spin-echo and FLAIR sequences were performed, followed by gadolinium-enhanced T1-weighted spin-echo and FLAIR sequences. Final diagnosis was based on the clinical findings and the analysis of cerebrospinal fluid, obtained by lumbar puncture after the MRI. Infectious meningitis was confirmed in 12 patients. In all of these patients of the plain studies, FLAIR was positive in only four patients. MRI gadolinium-enhanced FLAIR showed abnormal meningeal enhancement in all 12 patients, while gadolinium-enhanced T1-weighted spin-echo was positive only in six cases. There were no false-positive or false-negative results. It is concluded that MRI could have an important role in the early screening for infectious meningitis, provided a gadolinium-enhanced FLAIR sequence is used.

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