Subdural empyema MRI
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American Roentgen Ray Society Images of Subdural empyema MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; João André Alves Silva, M.D. [2]
Overview
Subdural empyema, also referred to as subdural abscess, pachymeningitis interna and circumscript meningitis, is a life-threatening infection.[1] It consists of a localised collection of purulent material, usually unilateral, between the dura mater and the arachnoid mater and accounts for about 15-22% of the reported focal intracranial infections The empyema may develop intracranially (about 95%) or in the spinal canal (about 5%), and in both cases, it constitutes a medical and neurosurgical emergency.[2] Following clinical evaluation, proper history taking, physical examinations and laboratory test results, the diagnosis of subdural empyema has to be confirmed by imaging studies.
MRI
MRI with gadolinium enhancement is considered the best imaging study for intracranial and spinal subdural empyema, with a sensitivity of 93%, since it reveals clearly the pus collections, as well as signs of meningeal infections. The characteristic image of a subdural empyema on an MRI is a fluid collection surrounded by a contrast-enhancing rim. It is used in emergent situations, with high level os suspicion, with the possibility of diagnosing subdural empyema at a time when symptoms are still confined to headache and fever, with absent focal neurologic signs. [2] The diffusion-weighted imaging method increases the diagnosis preciseness and offers the ability of monitoring antibiotic therapy. [3] The MRI should be careful evaluated for the presence of epidural abscess, meningitis, brain abscess and cerebral edema, with the possibility of showing sinusitis, otitis or mastoiditis. [2] MRI imaging studies demonstrate the subdural empyema as a convexity or interhemispheric collection, with a low signal on T1 and a high signal on T2 weighted images.[1]
References
- ↑ 1.0 1.1 Agrawal, Amit; Timothy, Jake; Pandit, Lekha; Shetty, Lathika; Shetty, J.P. (2007). "A Review of Subdural Empyema and Its Management". Infectious Diseases in Clinical Practice. 15 (3): 149–153. doi:10.1097/01.idc.0000269905.67284.c7. ISSN 1056-9103.
- ↑ 2.0 2.1 2.2 Greenlee JE (2003). "Subdural Empyema". Curr Treat Options Neurol. 5 (1): 13–22. PMID 12521560.
- ↑ Hendaus, Mohammed A. (2013). "Subdural Empyema in Children". Global Journal of Health Science. 5 (6). doi:10.5539/gjhs.v5n6p54. ISSN 1916-9744.