MRI in central nervous system infections: A simplified patterned approach

Recognition and characterization of central nervous system infections poses a formidable challenge to the neuro-radiologist.Imaging plays a vital role,the lesions typically being relatively inaccessible to tisue sampling.The results of an accurate diagnosis are endlessly re-warding,given the availab...

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Bibliographic Details
Published inWorld journal of radiology Vol. 6; no. 9; pp. 716 - 725
Main Author Rangarajan, Krithika
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 28.09.2014
Subjects
Central
Diffu-sion
imaging
Infection
Magnetic
nervous
Perfusion
resonance
Review
spectroscopy
system
weighted
Infection
Magnetic resonance spectroscopy
Magnetic resonance imaging
Perfusion weighted magnetic resonance imaging
Central nervous system
Diffusion weighted magnetic resonance imaging
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Summary:Recognition and characterization of central nervous system infections poses a formidable challenge to the neuro-radiologist.Imaging plays a vital role,the lesions typically being relatively inaccessible to tisue sampling.The results of an accurate diagnosis are endlessly re-warding,given the availability of excellent pharmaco-logical regimen.The availability of numerous magnetic resonance(MR)sequences which provide functional and molecular information is a powerful tool in the hands of the radiologist.However,the plethora of se-quences and the possibilities on each sequence is also intimidating,and often confusing as well as time con-suming.While a large number of reviews have already described in detail the possible imaging findings in each infection,we intend to classify infections based on their imaging characteristics.In this review we describe an algorithm for first classifying the imaging findings into patterns based on basic MR sequences(T1,T2 and enhancement pattern with Gadolinium),and then sub-classify them based on more advanced molecular and functional sequences(Diffusion,Perfusion,Susceptibili-ty imaging,MR Spectroscopy).This patterned approachis intended as a guide to radiologists in-training and in-practice for quickly narrowing their list of differentials when faced with a clinical challenge.The entire content of the article has also been summarised in the form of flow-charts for the purpose of quick reference.
Bibliography:Krithika Rangarajan;Chandan J Das;Atin Kumar;Arun Kumar Gupta;Department of Radiodiagnosis,All India Institute of Medical Sciences,Ansari Nagar East
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Correspondence to: Chandan J Das, MD, Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, Room number 60, New Delhi 110029, India. dascj@yahoo.com
Author contributions: Rangarajan K and Das CJ wrote most of the manuscript text as well as edited the images; Kumar A and Gupta AK provided valuable inputs, edited the manuscript and approved the content.
Telephone: +91-11-26594868
ISSN:1949-8470
1949-8470
DOI:10.4329/wjr.v6.i9.716