CentralNervousSystem

南京醫(yī)科大學一附院放射科洪汛寧hongxunning@2/3/20231CerebralAbscess

Brainabscessesmayberelatedtoinfectionsoftheparanasalsinuses,mastoids,middleearsaswellashematogenousseeding,butin20%ofcasesasourceisnotdiscovered.Presentingsymptomsofacerebralabscessincludeheadache,drowsiness,confusion,seizuresandfocalneurologicdeficits.Feverandleukocytosisarecommonduringtheinvasivephaseofacerebralabscessbutmayresolveastheabscessbecomesencapsulated.2/3/20232CerebralabscessRimenhancement–thinningtowardsventricularaspectDaughterlesionsHypointenseT2rimRestricteddiffusionofcontentmayreflectdensityofinflammatorycellsMRS:lactate(1.3ppm)andcytosolicaminoacidpeaks(0.9ppm)2/3/20233cerebralabscess2/3/202342/3/202352/3/202362/3/202375DAYSLATER2/3/202382/3/20239BacterialInfection:PyogenicInfectionGuptaRKetal.AJNR2001;22:1503-1509.

2/3/202310MeningitisRoleofimaging:identifycomplicationsSensitivityofMRimagingimprovedwithpostcontrastFLAIRimaging,fatsaturationT1WILookforhydrocephalus,abscessformation,infarct,ventriculitis2/3/202311BacterialInfection:PyogenicInfectionBacterialInfection:PyogenicInfectionBacterialInfection:PyogenicInfectionBacterialInfection:PyogenicInfectionBacterialInfection:PyogenicInfectionBacterialInfection:PyogenicInfectionEpiduralabscessTypicallyduetoextensionfromexternalsource(sinuses,mastoidaircells)orfollowingtrauma/surgeryDuraoftenpreventsassociatedparenchymalinvolvementLookforevidenceofsourceofinfectionandassociatedcerebritis2/3/202318BacterialInfection:PyogenicInfectionBacterialInfection:PyogenicInfectionBacterialInfection:PyogenicInfectionBacterialInfection:PyogenicInfectionBacterialInfection:PyogenicInfectionTBmeningoencephalitisCNSinfectionusuallyduetosecondaryhematogenousspreadSmallcorticalfociofinfectionrupturecausingmeningitisVasculitisandhydrocephaluscommonTuberculomas---maynotdemonstrateenhancementinearlyphase2/3/202324BacterialInfection:TuberculousInfectionBacterialInfection:TuberculousInfection2/3/2023272/3/202328BacterialInfection:TuberculousInfectionBacterialInfection:TuberculousInfectionBacterialInfection:TuberculousInfection2/3/2023322/3/2023332/3/2023342/3/2023352/3/2023362/3/202337HerpesmeningoencephalitisTypicallydemonstratetemporallobeinvolvement,oftenwithputaminalsparingCanfindRBCintapEarlytreatmentcrucialDWImoresensitiveinear