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Cranial imaging findings in neurobrucellosis results of Istanbul 3 study        
Yazarlar
Hakan Erdem
Sağlık Bilimleri Üniversitesi, Türkiye
Seniha Senbayrak
Kaan Meriç
Ayşe Batırel
Prof. Dr. Mustafa Kasım KARAHOCAGİL Prof. Dr. Mustafa Kasım KARAHOCAGİL
Ahi Evran Üniversitesi, Türkiye
Özet
Objective Neuroimaging abnormalities in central nervous system (CNS) brucellosis are not well documented. The purpose of this study was to evaluate the prevalence of imaging abnormalities in neurobrucellosis and to identify factors associated with leptomeningeal and basal enhancement, which frequently results in unfavorable outcomes.
Methods Istanbul-3 study evaluated 263 adult patients with CNS brucellosis from 26 referral centers and reviewed their 242 magnetic resonance imaging (MRI) and 226 computerized tomography (CT) scans of the brain.
Results A normal CT or MRI scan was seen in 143 of 263 patients (54.3 %). Abnormal imaging findings were grouped into the following four categories: (a) inflammatory findings: leptomeningeal involvements (44), basal meningeal enhancements (30), cranial nerve involvements (14), spinal nerve roots enhancement (8), brain abscesses (7), granulomas (6), and arachnoiditis (4). (b) White-matter involvement: white-matter involvement (32) with or without demyelinating lesions (7). (c) Vascular involvement: vascular involvement (42) mostly with chronic cerebral ischemic changes (37). (d) Hydrocephalus/cerebral edema: hydrocephalus (20) and brain edema (40). On multivariate logistic regression analysis duration of symptoms since the onset (OR 1.007; 95 % CI 1-28, p = 0.01), polyneuropathy and radiculopathy (OR 5.4; 95 % CI 1.002-1.013, p = 0.044), cerebrospinal fluid (CSF)/serum glucose rate (OR 0.001; 95 % CI 000-0.067, p = 0.001), and CSF protein (OR 2.5; 95 % CI 2.32.7, p = 0.0001) were associated with diffuse inflammation.
Conclusions In this study, 45 % of neurobrucellosis patients had abnormal neuroimaging findings. The duration of symptoms, polyneuropathy and radiculopathy, high CSF protein level, and low CSF/serum glucose rate were associated with inflammatory findings on imaging analyses.
Anahtar Kelimeler
Computerized tomography | Diagnosis | Inflammation | Magnetic resonance imaging | Neurobrucellosis
Makale Türü Özgün Makale
Makale Alt Türü SSCI, AHCI, SCI, SCI-Exp dergilerinde yayımlanan tam makale
Dergi Adı INFECTION
Dergi ISSN 0300-8126
Dergi Tarandığı Indeksler SCI
Makale Dili İngilizce
Basım Tarihi 10-2016
Cilt No 44
Sayı 5
Sayfalar 623 / 631
Doi Numarası 10.1007/s15010-016-0901-3
Makale Linki http://link.springer.com/10.1007/s15010-016-0901-3