Diagnostic value of isotropic three?dimensional fast spin echo?CUBE enhancement sequence in children with purulent meningitis / 中华放射学杂志

ABSTRACT

Objective To explore the clinical value of 3D fast spin echo with an extended echo train acquistion (CUBE) T1WI enhancement sequence for purulent meningitis by comparing to contrast?enhanced T2WI?FLAIR sequence in the detection of lesions. Methods From August 2016 to July 2017, children with clinically suspected purulent meningitis underwent cranial magnetic resonance examination in our hospital. There were 35 children, 19 males and 16 females, aged 2 months to 3 years (median age 8 months) in total.A GE Discovery MR 750 3.0 T scanner was used to perform routine plain and enhanced scan in all children. After enhancement, the sequences of CUBE T1WI and FLAIR T2WI were applied randomly. Using the FLAIR T2WI enhancement sequence as the reference, we evaluated the detection rate of CUBE T1WI enhancement sequence for dura mater and leptomeningeal thickening. The number of enhanced lesions detected was tested by χ2 test. Results The enhanced FLAIR T2WI sequence showed 21 cases with dural enhancement, showing a rate of 60.0%. The enhanced CUBE T1WI sequence showed 31cases with dural enhancement, showing a rate of 88.6%. There were significant differences between the dural lesions detected(χ2＝6.058, P<0.01). The enhanced FLAIR T2WI sequence showed 16 cases of leptomeningeal enhancement,showing a rate of 45.7%. The enhanced CUBE T1WI sequence showed 19 cases of leptomeningeal enhancement,showing a rate of 54.3%.The enhanced CUBE T1WI sequence was not significantly higher than that of enhanced T2WI?FLAIR sequence in displaying leptomeningeal enhancement (χ2=0.229, P>0.05). Conclusion Enhancement of the CUBE T1WI sequence enables better visualization of meningeal thickening than FLAIR T2WI. It has great clinical value in the diagnosis of purulent meningitis in children.