European Journal of Molecular & Clinical Medicine

Abstract

Aims and objectives: To study the role of Magnetic Resonance Imaging in diagnosis of
paediatric brain infections, characterization of various patterns of brain involvement
and establishing the differential diagnosis along with role of Diffusion Weighted
Imaging and Apparent Diffusion Coefficient in Cerebral infections .
Materials and methods: 50 cases with suspected brain infection, whose age group
ranged from 0-14 years, referred to the Department of Radiodiagnosis and Imaging,
Government Medical College, Amritsar, were included in this study. The sequences
performed were T1W axial, T2W axial, coronal and saggital, FLAIR axial, DWI/ADC,
SWI,post contrast T1W in all patients and magnetic resonance spectroscopy wherever
required. MRI findings in all cases along with magnetic resonance spectroscopy, clinical
and biochemical findings (wherever required) were taken into consideration to arrive at
a diagnosis.
Results:Outof50patients,mostcommonpathologywastubercularinfectionsseen in 25
patients (50%), followed by 18 patients of pyogenic meningitis (36%), 5 patients of NCC
(10%) and 2 patients of viral encephalitis (4%). The most common finding in tubercular
infections was meningeal enhancement followed by tuberculomas, basal exudatesand
themostcommon complication was hydrocephalus. Themostcommon finding in pyogenic
meningitis was meningeal enhancement and the most common complication was
abscess. Neurocysticercosis lesions were parenchymal. Colloidal vesicular/granular
nodular stage was seen in 3 patients, vesicular in 2 patients and calcified in 1 patient.
Viral encephalitis was seen as areas of cerebral involvement bilaterally with restriction
on DWI/ADC seen in onepatient.
Conclusions: MRI due to its variable intensities in multiple sequences aided by contrast
enhancement helps the radiologist to arrive at an almost exact diagnosis. Italso
drawssupportfromassociatedclinicalfeatures, lesion-staging, complicationsand number
(single or multiple) of the lesions. Thus it scores over CT and ultrasound as basic
modalities for imaging infective disease of brain inchildren.