Subdural empyema MRI
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]; Anthony Gallo, B.S. [3]
Overview
MRI in the optimal imaging study in the diagnosis of subdural empyema. Findings on MRI suggestive of subdural empyema are similar to those on CT scan, and include crescent shaped collection, though collection pockets may appear bi-convex. A surrounding membrane that enhances intensely and uniformly following gadolinium enhancement is typically identified and may also demonstrate restricted diffusion.[1]
MRI
MRI with gadolinium enhancement is considered the optimal imaging study for intracranial and spinal subdural empyema. MRI clearly reveals pus collections, and potentially meningitis. The characteristic image suggestive of a subdural empyema on an MRI is a fluid collection in a crescent shape surrounded by a contrast-enhancing rim. On MRI, subdural empyema appears with a low signal on T1 and a high signal on T2 weighted images.[2] MRI can be used in emergent situations, with high level of suspicion, with the possibility of diagnosing subdural empyema at a time when symptoms are still headache and fever, with absent focal neurologic signs.[3] The diffusion-weighted imaging method increases the diagnosis preciseness and offers the ability of monitoring antibiotic therapy.[4] Additionally, the MRI should be evaluated for the presence of epidural abscess, meningitis, brain abscess, cerebral edema, sinusitis, otitis and mastoiditis.[3]
References
- ↑ Subdural empyema. Radiopaedia.org (2015). http://radiopaedia.org/articles/subdural-empyema Accessed on December 4, 2015.
- ↑ 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.
- ↑ 3.0 3.1 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.