title: A prospective study of magnetic resonance imaging patterns of central nervous system infections in pediatric age group and young adults and their clinico-biochemical correlation.
abstract: BACKGROUND
  Infections of the central nervous system (CNS) are common and routinely encountered. Our aim was to evaluate the neuroimaging features of the various infections of the CNS so as to differentiate them from tumoral, vascular, and other entities that warrant a different line of therapy.
  
  
  OBJECTIVE
  Our aim was to analyze the biochemical and magnetic resonance imaging (MRI) features in CNS infections.
  
  
  METHODS
  This was a longitudinal, prospective study over a period of 1½ years.
  
  
  METHODS
  We studied cerebrospinal fluid (CSF) findings and MRI patterns in 27 patients of 0-20 years age group with clinical features of CNS infections. MRI was performed on MAGNETOM Avanto 18 Channel 1.5 Tesla MR machine by Siemens India Ltd. The MRI protocol consisted of diffusion-weighted and apparent diffusion coefficient imaging, turbo spin echo T2-weighted, spin echo T1-weighted, fluid-attenuated inversion recovery (FLAIR), and gradient-echo in axial, FLAIR in coronal, and T2-weighted in sagittal plane. Contrast-enhanced T1-weighted sequence and MR spectroscopy were done whenever indicated.
  
  
  CONCLUSIONS
  We found that most of the children belong to 1-10 years age group. Fungal infections were uncommon, mean CSF adenosine deaminase values specific for tuberculosis and mean CSF glucose-lowered in pyogenic. Hemorrhagic involvement of thalamus with/without basal ganglia and brainstem involvement may indicate Japanese encephalitis or dengue encephalitis. Diffusion restriction or hemorrhage in not expected in the brainstem afflicted lesions of rabies. Congenital cytomegalovirus can cause cortical malformations. T1 hyperintensities with diffusion restriction may represent viral encephalitis. Lesions of acute disseminated encephalomyelitis (ADEM) may mimic viral encephalitis. Leptomeningeal enhancement is predominant in pyogenic meningitis. Basilar meningitis in the presence of tuberculomas is highly sensitive and specific for tuberculosis.
authors.affiliation: Department of Radiodiagnosis, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
authors.forename: Kamini
authors.initials: K
authors.lastname: Gupta
authors.affiliation: Department of Radiodiagnosis, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
authors.forename: Avik
authors.initials: A
authors.lastname: Banerjee
authors.affiliation: Department of Radiodiagnosis, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
authors.forename: Kavita
authors.initials: K
authors.lastname: Saggar
authors.affiliation: Department of Radiodiagnosis, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
authors.forename: Archana
authors.initials: A
authors.lastname: Ahluwalia
authors.affiliation: Department of Dentistry, Baba Jaswant Singh Dental College, Ludhiana, Punjab, India.
authors.forename: Karan
authors.initials: K
authors.lastname: Saggar
keywords: Encephalitis; hyperintense; magnetic resonance imaging; meningitis; pyogenic; tuberculosis