Role Of Imaging In Intracranial Infections And Infestations
Imaging In Intracranial Infections And Infestation
Keywords:
CNS Imaging, CT, Tuberculoma, Neurocysticercosis, Brain Abscess, Meningitis, MRIAbstract
Background and Objective: Conventional X –rays and cranial ultrasound have limited role in central nervous system infections and infestations, neuroimaging with CT and MRI plays significant role in understanding and diagnosing these diseases. The aims and objectives of this study are to study the CT and MRI appearance in CNS infection and infestations according to the age, sex, location, duration etiology and to analyze clinico-pathological confirmation with imaging findings and to evaluate their accuracy in final diagnosis. Methodology: This prospective study of 120 patients of all age group with no gender bias, religion or socio-economic status except pregnant patients and patients having allergy to contrast material, patients with cochlear implants, cardiac pacemaker and Ferro- magnetic orthopedic implants was done during January 2014 to June 2015 using non-contrast and contrast enhanced CT and MRI scans. Result: In this study of 120 patients, CNS infection occurred maximum between 1 – 10 years of age (26.67%) followed by the group 21-30 years (21.67%). The ratio of male: female was found to be 1.07:1. Fever emerged as the overall most common presenting clinical symptom and generalized tonic clonic convulsions as the most common neurological symptom. Supratentorial lesions were more frequent (96.67%) Non contrast MRI was found to be more effective in detection of the CNS pathology together with hemorrhage (80% of cases). Non- contrast CT scan proved to be very accurate in detection of calcification (60%) while MRI was positive only in 40% of cases. MRI proved to be more positive in detection of edema (84.21%) unlike CT which showed only 15.67%. On post contrast MRI picked up 55% of cases with ring lesions while CT was able to detect them only in 45% of cases. MRI detected meningeal enhancement of 72.2% cases and mass effect in 76.1% of cases. While CT detected meningeal enhancement of CNS (27.78%) and mass effect in 23.08% cases. Conclusion: MRI provided better sensitivity with clinic- pathological correlation which can guide clinicians in treatment and prognosis while CT scan can be used as an initial modality of investigation and it has advantage of being done in few seconds. The comparisons were made between diabetic females of both the phases (menstruation and menopause) and age matched non-diabetic females. Further comparisons were made between diabetic females of menopause phase and diabetic females of menstruation phase. [Satodia D NJIRM 2015; 6(6):51-58]
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