Diagnostic Accuracy of Post Contrast Magnetic Resonance Imaging for Meningitis Taking Lumbar Puncture as Gold Standard. Experience at Nishtar Hospital-Multan

Jesrani, Ameet

doi:10.46718/jbgsr.2020.06.000150

Cited by 3 publications

(2 citation statements)

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“…Their study shows relatively reduced sensitivity compared to our study likely due to population studied and difference in inclusion criterion. 17 In a study done in Europe by Parmar et al on 24 patients, the sensitivity and specificity of CE T2 FLAIR was found to be 85%. 18 A study done by Ahmad A et al, in which not only they did qualitative accuracy but also did quantitative analysis using single pixel signal intensities (SPSI) for CE T2 FLAIR.…”

Section: Discussionmentioning

confidence: 94%

Diagnostic Accuracy of Contrast Enhanced T2 Flair in Diagnosing Infective Meningitis Considering CSF Analysis as Gold Standard

Muhammad Sehran Khalid,

Sadaf Arooj,

Aisha Asghar

et al. 2023

Pak Postgrad Med J.

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OBJECTIVE: To determine diagnostic accuracy of contrast enhanced T2 FLAIR in diagnosing infective meningitis considering CSF analysis as gold standard. METHODS: A prospective study of 101 patients with clinical suspicion of meningitis, referred to the radiology department of Mayo Hospital Lahore for MRI examination was done. Patients with reduced renal function, claustrophobia and metallic implants were excluded from the study. The MRI brain with contrast including postcontrast T1WI and FLAIR sequences was performed at 1.5 T machine. The images then evaluated by the competent experienced radiologists. Cerebrospinal fluid (CSF) analysis of the patients was done through lumbar puncture and was considered the “gold standard” against which comparison of MRI findings was done. Data analysis was done by using SPSS 23. RESULTS: Sensitivity and specificity of contrast enhanced T2 FLAIR MRI in detecting infective meningitis was 95.08% (CI-95%: 86.51-98.31) and 82.5% (CI-95%: 68.05, 91.25). While positive predictive value and negative predictive value was 89.23% (CI-95%: 79.4, 94.68) and 91.67% (CI-95%: 78.17, 97.13) respectively. Diagnostic accuracy was 90.1% respectively. CONCLUSION: Results of this study showed higher sensitivity and specificity for contrast enhanced T2 FLAIR in diagnosing infective meningitis. So use of contrast enhanced T2 FLAIR can be helpful in early screening and diagnosis of meningeal infections.

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Section: Discussionmentioning

confidence: 94%

Diagnostic Accuracy of Contrast Enhanced T2 Flair in Diagnosing Infective Meningitis Considering CSF Analysis as Gold Standard

Muhammad Sehran Khalid,

Sadaf Arooj,

Aisha Asghar

et al. 2023

Pak Postgrad Med J.

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“…It is still one of the major causes of mortality and morbidity in children all over the world. 1 Worldwide there are almost 135000 deaths due to bacterial meningitis every year. 2 Streptococcus pneumonia is one of the leading pathogens in children causing the meningitis along with Neisseria meningitides.…”

Section: Introductionmentioning

confidence: 99%

Vaccination Status and Clinical Spectrum of Children with Pyogenic Meningitis in A Tertiary Care Hospital of Hazara Division, Pakistan

Aalia

Shah

2021

J Islamabad Med Dental Coll

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Background: Pyogenic meningitis is one of the serious causes of mortality and morbidity in children. It is more prevalent in third world countries with poor vaccination coverage. This study was done to determine the vaccination status and clinical spectrum of pyogenic meningitis in children presenting to a tertiary care hospital. Methods: This cross-sectional study was carried out from August, 2017 till January, 2020 over 2.5 years. Records of children who got admitted in pediatric B ward, of either gender between ages of 1 month to 14 years diagnosed as case of pyogenic meningitis were included. Records of vaccination status along with signs of meningeal irritation, complications and outcome during hospital stay were documented. Data was analyzed by SPSS 20 and chi square test applied. P value < 0.05 was taken as significant. Results: There were 117 patients, 78 males and 39 females. Age ranged from 1 month to 14 years with mean age of 5.51± 4.19 years. Patients who were vaccinated up to date were 49.6% and 37.6% were not vaccinated at all. Main presenting feature was fever and seizures especially under one year of age. There was significant association between seizures and age group with p value of 0.001. Signs of meningeal irritation (neck stiffness, brudzinski sign, kerning sign) and paradoxical irritability were present in 85 (72.6%) patients mostly above 1 year of age. There was significant association between signs of meningeal irritation and age group (5 years and above) with p value of <0.001. 110 (94%) got discharged and one (0.9%) patient was referred while 6 (5.1%) patients expired. There was significant association between stay duration and vaccination status. (p = 0.018) Conclusion: Fever was the most common presentation and vaccinated children with pyogenic meningitis had shorter stay in hospital.

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Positive Predictive Value of Contrast-Enhanced Fluid-Attenuated Inversion Recovery (FLAIR) Magnetic Resonance Imaging in Diagnosis of Meningitis Among Pediatrics Taking Cerebrospinal Fluid Analysis as Gold Standard

Shabbir,

Sheikh

2024

Cureus

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Background and objective: Cerebrospinal fluid (CSF) analysis is the gold standard for meningitis diagnosis. It is invasive, time-consuming, and can inoculate infection. CSF analysis is not appropriate for many children without significant clinical suspicion, and delaying decision-making can have negative consequences. Therefore, medical research has long focused on speedy, non-invasive meningitis diagnosis. This study aimed to examine the positive predictive value (PPV) of contrast-enhanced fluid-attenuated inversion recovery magnetic resonance imaging (CE-FLAIR MRI) in meningitis diagnosis. Materials and methods: It was a cross-sectional study that was conducted in the Department of Radiology, The Children’s Hospital in Lahore, from December 29, 2017, to June 28, 2018. The 198 patients were included of either gender with an age of 1 to 15 years and underwent CE-FLAIR MRI due to suspicion of meningitis. The gold standard for meningitis diagnosis was cerebrospinal fluid analysis, while CE-FLAIR MRI results were graded as true positives and false positives. The chi-square test was used. The p -value less than 0.05 was taken as statistically significant. Results: The mean age of the patients was 4.18±2.48 years. The majority, 116 (58.6%), of the patients were aged below 5 years. There were 125 (63.1%) male and 73 (36.9%) female patients with a male-to-female ratio of 1.7:1. The diagnosis of meningitis using CE-FLAIR MRI was made in 187 (94.4%) patients with a PPV of 94.4%, which was further confirmed on CSF analysis. The PPV of CE-FLAIR-MRI across various subgroups based on the patient's age and gender were statistically insignificant, which showed consistency across all included age and gender groups ( p > 0.05). Conclusion: The contrast-enhanced FLAIR magnetic resonance imaging was found to have a high positive predictive value of 94.4% in the diagnosis of meningitis, taking cerebrospinal fluid analysis as the gold standard. CE-FLAIR MRI’s noninvasive and ionizing radiation-free characteristics advocate its preferred use in future clinical practice.

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Diagnostic Accuracy of Post Contrast Magnetic Resonance Imaging for Meningitis Taking Lumbar Puncture as Gold Standard. Experience at Nishtar Hospital-Multan

Cited by 3 publications

References 0 publications

Diagnostic Accuracy of Contrast Enhanced T2 Flair in Diagnosing Infective Meningitis Considering CSF Analysis as Gold Standard

Diagnostic Accuracy of Contrast Enhanced T2 Flair in Diagnosing Infective Meningitis Considering CSF Analysis as Gold Standard

Vaccination Status and Clinical Spectrum of Children with Pyogenic Meningitis in A Tertiary Care Hospital of Hazara Division, Pakistan

Positive Predictive Value of Contrast-Enhanced Fluid-Attenuated Inversion Recovery (FLAIR) Magnetic Resonance Imaging in Diagnosis of Meningitis Among Pediatrics Taking Cerebrospinal Fluid Analysis as Gold Standard

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