title: Arterial spin-labeling perfusion imaging of childhood meningitis: a case series.
abstract: BACKGROUND
  Conventional magnetic resonance imaging (MRI), which is mainly used to detect complications, is ineffective in determining the neurological status of patients with meningitis. Hemodynamic change in the brain may be more indicative of the neurological status but few imaging studies have verified this. Arterial spin-labeling (ASL) perfusion, a noninvasive MR method requiring no contrast agent injection, can be used to measure cerebral blood flow (CBF).
  
  
  METHODS
  We describe three pediatric patients with meningitis, who all showed regions of increased CBF on perfusion imaging. One patient, presenting with headache and conscious disturbance, had CBF changes in the frontal, temporal, and occipital regions. The other two patients, presenting with hallucinations, memory deficits, and seizures, had CBF changes in the frontal and temporal regions.
  
  
  CONCLUSIONS
  ASL perfusion imaging may be helpful in assessing patients with meningitis, demonstrating CBF changes more strongly correlating with the neurological status, and detecting active brain abnormalities.
authors.affiliation: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Keelong, Linkou Medical Center and Chang Gung University, 5 Fu-Hsing Street, Tao Yuan, 333, Taiwan.
authors.forename: Alex Mun-Ching
authors.initials: AM
authors.lastname: Wong
authors.affiliation: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Keelong, Linkou Medical Center and Chang Gung University, 5 Fu-Hsing Street, Tao Yuan, 333, Taiwan.
authors.forename: Chih-Hua
authors.initials: CH
authors.lastname: Yeh
authors.affiliation: Department of Imaging Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Ho-Ling
authors.initials: HL
authors.lastname: Liu
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung University, Linkou, Taiwan.
authors.forename: Kuang-Lin
authors.initials: KL
authors.lastname: Lin
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung University, Linkou, Taiwan.
authors.forename: Huei-Shyong
authors.initials: HS
authors.lastname: Wang
authors.affiliation: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Keelong, Linkou Medical Center and Chang Gung University, 5 Fu-Hsing Street, Tao Yuan, 333, Taiwan. alexmcwchop@gmail.com.
authors.forename: Cheng-Hong
authors.initials: CH
authors.lastname: Toh
mesh_terms: D000293:Adolescent; D002560:Cerebrovascular Circulation / Q000502:physiology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008581:Meningitis / Q000175:diagnosis* / Q000473:pathology*; D055420:Perfusion Imaging / Q000379:methods*; D013113:Spin Labels
chemical_list: D013113:Spin Labels
keywords: Arterial spin-labeling perfusion; Cerebral blood flow; Meningitis