1. Tuberculous meningitis: Comparison of contrast enhanced T1-weighted and flair MR imaging with magnetization transfer contrast
- Author
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Z Pekkafali, Mecit Kantarci, E. Silit, C.C. Basekim, H. Mutlu, and E. Kizilkaya
- Subjects
Contrast enhancement ,Radiological and Ultrasound Technology ,business.industry ,media_common.quotation_subject ,Fluid-attenuated inversion recovery ,medicine.disease ,Mr imaging ,Tuberculous meningitis ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Nuclear magnetic resonance ,medicine.anatomical_structure ,T1 weighted ,Medicine ,Contrast (vision) ,Radiology, Nuclear Medicine and imaging ,Neurology (clinical) ,Magnetization transfer ,Subarachnoid space ,business ,human activities ,030217 neurology & neurosurgery ,media_common - Abstract
Fluid-attenuated inversion recovery (FLAIR) imaging with contrast enhancement is highly sensitive for detecting subarachnoid space disease. We hypothesized that contrast-enhanced FLAIR imaging with magnetization transfer would offer superior sensitivity to contrast-enhanced T1-weighted MR imaging with magnetization transfer in detecting TB meningitis. Forty-four patients referred for suspected TB meningitis underwent MR imaging studies. The patients had either proven TB meningitis or negative TB meningitis. The MR imaging examinations included both contrast-enhanced FLAIR and T1-weighted MR images with magnetization transfers that were independently reviewed by two neuroradiologists. Each of the sequences was reviewed individually and separately and was assigned a score of positive or negative for TB meningitis. Of the 21 studies of patients with proven TB meningitis, nine were positive based on contrast-enhanced FLAIR images with magnetization transfer, and 13 were positive based on contrast-enhanced T1-weighted MR images with magnetization transfer. Of the 23 studies of patients without TB meningitis, 19 were negative based on contrast-enhanced FLAIR images, and 20 were negative based on contrast-enhanced T1-weighted MR images with magnetization transfer. The sensitivity and specificity for contrast-enhanced FLAIR images for detecting TB meningitis were 43% (nine of 21) and 82% (19 of 23), respectively. The sensitivity and specificity of contrast-enhanced T1-weighted MR images with magnetization transfer for detecting TB meningitis were 62% (13 of 21) and 87% (20 of 23), respectively. Contrast-enhanced FLAIR imaging with magnetization transfer is less sensitive than contrast-enhanced T1-weighted MR sequences with magnetization transfer in detecting TB meningitis.