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Congress: ECR25
Poster Number: C-12858
Type: Poster: EPOS Radiologist (educational)
Authorblock: E. Akçiçek, A. E. Aldur, R. Göçmen; Ankara/TR
Disclosures:
Esra Akçiçek: Nothing to disclose
Ali Enes Aldur: Nothing to disclose
Rahşan Göçmen: Nothing to disclose
Keywords: Neuroradiology brain, Neuroradiology spine, MR, Imaging sequences, Cerebrospinal fluid, Inflammation
Learning objectives The objectives are to describe leptomeningeal (LM) diseases, characterize topographical distribution, enhancement pattern, and provide a differential diagnosis based on the imaging findings.
Read more Background There is a wide variety of leptomeningeal diseases. In order to narrow the differential diagnosis, patterns of LM enhancement are highly valuable: The location (basal or vertex), distribution (diffuse or focal), thickness (thick or thin), and laterality (unilateral or bilateral), nodular or linear and smooth or irregular involvement. Demonstrating patterns of LM contrast enhancement with illustrations (Fig. 24), along with diffusion-weighted imaging, T1-weighted, and T2-weighted imaging findings, is essential for accurate differential diagnosis.
Read more Findings and procedure details There are various diseases that can cause LM involvement, which can be categorized into subgroups based on the pathogenesis of the involvement:Infectious: Viral: Viruses can cause meningitis and/or encephalitis, with clinical and imaging findings resembling acute pyogenic meningitis but typically milder (1). Imaging is often unremarkable but may reveal subtle, thin linear LM enhancement, with parenchymal enhancement present in cases of associated encephalitis (2) (Fig.1).Bacterial: Bacterial meningitis is a life-threatening neurological emergency that demands rapid diagnosis and treatment. MRI findings...
Read more Conclusion A wide range of diseases can cause leptomeningeal involvement, including some that are rarely encountered. Radiological imaging plays a crucial role in differentiating these conditions. To narrow the differential diagnosis, patterns of leptomeningeal contrast enhancement are particularly valuable, including considerations of location, distribution, thickness, laterality, and whether the involvement is nodular or linear, as well as smooth or irregular.
Read more References References  Mohan S, Jain KK, Arabi M, Shah GV. Imaging of meningitis and ventriculitis. Neuroimaging Clinics of North America. 2012;22(4):557-83. Duong MT. Neuroimaging Patterns of Intracranial Infections. Central Nervous System Infections, An Issue of Neuroimaging Clinics of North America. 2022;33(1):11. Hughes D, Raghavan A, Mordekar S, Griffiths P, Connolly D. Role of imaging in the diagnosis of acute bacterial meningitis and its complications. Postgraduate medical journal. 2010;86(1018):478-85. Duarte SBL, Oshima MM, Mesquita JVdA, Nascimento FBPd, Azevedo PCd, Reis F. Magnetic resonance imaging findings in...
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