DIAGNOSTIC ACCURACY OF CONTRAST ENHANCED T2 FLAIR IN DIAGNOSING INFECTIVE MENINGITIS CONSIDERING CSF ANALYSIS AS GOLD STANDARD

Muhammad Sehran Khalid; Sadaf Arooj; Aisha Asghar; Ali  Mansoor; Mahjabeen Masood; Faiza Afzal

doi:10.51642/ppmj.v34i03.606

Muhammad Sehran Khalid King Edward Medical University/Mayo Hospital lahore
Sadaf Arooj Allama Iqbal Medical College, Lahore
Aisha Asghar Mayo Hospital Lahore
Ali Mansoor Mayo Hospital, Lahore
Mahjabeen Masood King Edward Medical University / Mayo Hospital, Lahore
Faiza Afzal Badralsamaa Medical Centre, Alkhuwair, Muscat, Oman.

DOI: https://doi.org/10.51642/ppmj.v34i03.606

Keywords: Meningitis, CSF, Diagnostic accuracy, Magnetic Resonance Imaging, Contrast Enhanced FLAIR

Abstract

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.