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961 The Diagnostic Value of Neuroimaginig in Recognizing and Therapy Monitoring of Encephalitis and Meningitis in Children
  1. J Surmik1,
  2. E Emich-Widera2,
  3. J Wróblewska1,
  4. I Maruniak-Chudek1,
  5. E Kluczewska3
  1. 1Department of Neonatal Intensive and Special Care
  2. 2Department of Neuropediatrics, Medical University of Silesia, Katowice
  3. 3Department of Radiology and Radiodiagnostics, Medical University of Silesia, Zabrze, Poland

Abstract

Background and Aims Neuroinfection is an entity with possible serious subsequent complications. Early and precise diagnosis can help in purposeful treatment and accurate prognosis. The aim of the study was the analysis of principles and value of neuroimaging in the diagnostic process in pediatric neuroinfection.

Methods The retrospective analysis comprised 74 patients diagnosed with encephalitis and/or meningitis. The cohort was divided into two groups: A (meningitis; n=45) and B (encephalitis and meningoencephalitis, n=29). Data obtained from medical records (medical history, signs and symptoms, results of laboratory tests and radiological imaging) were investigated. Computer tomography (CT) or magnetic resonance (MR) were performed in the study group.

Results In the group A first CT examination revealed abnormalities in 9.7% of patients, in the group B - in 28% of children. MR examination showed pathological brain area in 79.3% of patients in group B. High signal in SE/T2 was observed in 95.7% and in FLAIR in 86.9%. In 90% of analyzed group B the disturbances in DWI were noted.

Conclusions CT examination preformed in the initial stadium of meningitis and/or encephalitis has limited diagnostic value for recognizing of inflammation. The characteristic of the abnormalities revealed by MR enables to recognize inflammation changes in central nervous system and their localization can direct diagnostic process. The presence of brain tissue alterations in MR image has significant correlation with clinical symptoms like seizures, consciousness disturbances and neurological deficits. The most sensitive sequences in estimation of the inflammation activity process are DWI and FLAIR.

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