Accuracy of Hyperintense Cerebrospinal Fluid Signals (CSF) on Inversion Recovery (IR) Images of Brain in the Diagnosis of Meningitis-a Cost Effective Experience from Third World Country

Abstract

Objective: To detect the diagnostic accuracy of inversion recovery sequence in detection of meningitis taking cerebrospinal fluid as the gold standard. Material and Methods: This study was conducted in Aga Khan University Hospital (AKUH) Karachi. Retrospective data was reviewed from 1ST November 2010 to 31st November 2012. All consecutive patients who came with clinical diagnosis of meningitis were included. Fifty patients were included in study on the basis of inclusion and exclusion criteria. Two independent neuroradiologists retrospectively reviewed FLAIR sequences blinded to CSF findings. Their findings were compared with cerebrospinal fluid results.  Sensitivity, specificity, PPV, NPV and diagnostic accuracy were calculated. Results: Hyperintense CSF signals on FLAIR sequence found to have 94.7% sensitivity, 83.3% specificity and accuracy of 92% in diagnosis of meningitis while PPV and NPV were 94.7% and 83.3% respectively. Conclusion: We found that hyper intense CSF signals on FLAIR sequence has high accuracy in diagnosis of meningitis.