Diagnostic performance of contrast-enhanced T2-FLAIR MRI in the detection of meningitis
Background: The contrast-enhanced T2-FLAIR (CE-T2-FLAIR) sequence on MRI, through the suppression of CSF and vascular signals, can detect subtle meningeal enhancement in meningitis that may not be appreciable on the routinely used contrast-enhanced T1W (CE-T1W) sequence. Objectives: To assess CE-T2...
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| Language: | English |
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AOSIS
2025-01-01
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| Series: | South African Journal of Radiology |
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| Online Access: | https://sajr.org.za/index.php/sajr/article/view/3018 |
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| author | Sanjay P. Vittal Manohar Sushmita Balol Yashwanth Naik M.B. |
| author_facet | Sanjay P. Vittal Manohar Sushmita Balol Yashwanth Naik M.B. |
| author_sort | Sanjay P. |
| collection | DOAJ |
| description | Background: The contrast-enhanced T2-FLAIR (CE-T2-FLAIR) sequence on MRI, through the suppression of CSF and vascular signals, can detect subtle meningeal enhancement in meningitis that may not be appreciable on the routinely used contrast-enhanced T1W (CE-T1W) sequence.
Objectives: To assess CE-T2-FLAIR compared to CE-T1W in the diagnosis of meningitis, using CSF analysis as the gold standard, using both qualitative and quantitative approaches for assessment.
Method: A retrospective study was conducted on 53 patients with clinically suspected meningitis referred for brain MRI. Twenty-seven patients, positive for meningitis on CSF analysis, were classified as the case group; the remaining patients were designated as controls. The pre-contrast, CE-T1W and CE-T2-FLAIR images were assessed and analysed, qualitatively for the detection of abnormal meningeal enhancement, and quantitatively by measuring single pixel signal intensities (SPSI) over the meninges and vessels.
Results: Contrast-enhanced T2-FLAIR demonstrated significantly higher sensitivity (92.59% vs. 57.69%), negative predictive value (92.59% vs. 70.27%) and diagnostic accuracy (94.34% vs. 78.85%) compared to CE-T1W. Additionally, CE-T2-FLAIR showed significantly greater meningeal SPSI and enhancement than CE-T1W.
Conclusion: Contrast-enhanced T2-FLAIR is better at detecting abnormal meningeal enhancement in meningitis than CE-T1W, because of significantly greater signal intensity and enhancement of the meninges compared to vessels.
Contribution: This study reiterates the usefulness of CE-T2-FLAIR as an additional sequence for the detection of abnormal meningeal enhancement in cases of meningitis as confirmed both qualitatively and quantitatively. |
| format | Article |
| id | doaj-art-bcc544e0e3e9441990b9bcf374a60893 |
| institution | Kabale University |
| issn | 1027-202X 2078-6778 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | AOSIS |
| record_format | Article |
| series | South African Journal of Radiology |
| spelling | doaj-art-bcc544e0e3e9441990b9bcf374a608932025-02-11T13:30:58ZengAOSISSouth African Journal of Radiology1027-202X2078-67782025-01-01291e1e910.4102/sajr.v29i1.30181281Diagnostic performance of contrast-enhanced T2-FLAIR MRI in the detection of meningitisSanjay P.0Vittal Manohar1Sushmita Balol2Yashwanth Naik M.B.3Department of Radiodiagnosis, Mysore Medical College and Research Institute, MysoreDepartment of Radiodiagnosis, Mysore Medical College and Research Institute, MysoreDepartment of Radiodiagnosis, Mysore Medical College and Research Institute, MysoreDepartment of Radiodiagnosis, Mysore Medical College and Research Institute, MysoreBackground: The contrast-enhanced T2-FLAIR (CE-T2-FLAIR) sequence on MRI, through the suppression of CSF and vascular signals, can detect subtle meningeal enhancement in meningitis that may not be appreciable on the routinely used contrast-enhanced T1W (CE-T1W) sequence. Objectives: To assess CE-T2-FLAIR compared to CE-T1W in the diagnosis of meningitis, using CSF analysis as the gold standard, using both qualitative and quantitative approaches for assessment. Method: A retrospective study was conducted on 53 patients with clinically suspected meningitis referred for brain MRI. Twenty-seven patients, positive for meningitis on CSF analysis, were classified as the case group; the remaining patients were designated as controls. The pre-contrast, CE-T1W and CE-T2-FLAIR images were assessed and analysed, qualitatively for the detection of abnormal meningeal enhancement, and quantitatively by measuring single pixel signal intensities (SPSI) over the meninges and vessels. Results: Contrast-enhanced T2-FLAIR demonstrated significantly higher sensitivity (92.59% vs. 57.69%), negative predictive value (92.59% vs. 70.27%) and diagnostic accuracy (94.34% vs. 78.85%) compared to CE-T1W. Additionally, CE-T2-FLAIR showed significantly greater meningeal SPSI and enhancement than CE-T1W. Conclusion: Contrast-enhanced T2-FLAIR is better at detecting abnormal meningeal enhancement in meningitis than CE-T1W, because of significantly greater signal intensity and enhancement of the meninges compared to vessels. Contribution: This study reiterates the usefulness of CE-T2-FLAIR as an additional sequence for the detection of abnormal meningeal enhancement in cases of meningitis as confirmed both qualitatively and quantitatively.https://sajr.org.za/index.php/sajr/article/view/3018meningitismeningesabnormal meningeal enhancementcontrast-enhanced t2-flaircontrast-enhanced t1wmagnetic resonance imagingsingle pixel signal intensitycentral nervous systemretrospective study. |
| spellingShingle | Sanjay P. Vittal Manohar Sushmita Balol Yashwanth Naik M.B. Diagnostic performance of contrast-enhanced T2-FLAIR MRI in the detection of meningitis South African Journal of Radiology meningitis meninges abnormal meningeal enhancement contrast-enhanced t2-flair contrast-enhanced t1w magnetic resonance imaging single pixel signal intensity central nervous system retrospective study. |
| title | Diagnostic performance of contrast-enhanced T2-FLAIR MRI in the detection of meningitis |
| title_full | Diagnostic performance of contrast-enhanced T2-FLAIR MRI in the detection of meningitis |
| title_fullStr | Diagnostic performance of contrast-enhanced T2-FLAIR MRI in the detection of meningitis |
| title_full_unstemmed | Diagnostic performance of contrast-enhanced T2-FLAIR MRI in the detection of meningitis |
| title_short | Diagnostic performance of contrast-enhanced T2-FLAIR MRI in the detection of meningitis |
| title_sort | diagnostic performance of contrast enhanced t2 flair mri in the detection of meningitis |
| topic | meningitis meninges abnormal meningeal enhancement contrast-enhanced t2-flair contrast-enhanced t1w magnetic resonance imaging single pixel signal intensity central nervous system retrospective study. |
| url | https://sajr.org.za/index.php/sajr/article/view/3018 |
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