Cranial imaging findings in neurobrucellosis: results of Istanbul-3 study.
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Erdem Hakan, Senbayrak Seniha, Meriç Kaan, Batirel Ayşe, Karahocagil Mustafa Kasım, Hasbun Rodrigo, Sengoz Gonul, Karsen Hasan, Kaya Selçuk, Inal Ayşe Seza, Pekok Abdullah Umut, Celen Mustafa Kemal, Deniz Secil, Ulug Mehmet, Demirdal Tuna, Namiduru Mustafa, Tekin Recep, Guven Tumer, Parlak Emine, Bolukcu Sibel, Avci Meltem, Sipahi Oguz Reşat, Ozturk-Engin Derya, Yaşar Kadriye, Pehlivanoglu Filiz, Yilmaz Emel, Ates-Guler Selma, Mutlu-Yilmaz Esmeray, Tosun Selma, Sirmatel Fatma, Sahin-Horasan Elif, Akbulut Ayhan, Oztoprak Nefise, Cag Yasemin, Kadanali Ayten, Turgut Huseyin, Baran Ali Irfan, Gul Hanefi Cem, Sunnetcioglu Mahmut, Haykir-Solay Asli, Denk Affan, Inan Asuman, Ayaz Celal, Ulcay Asim, Kose Sukran, Agalar Canan, Elaldi Nazif
Аннотация
METHODS: Istanbul-3 study evaluated 263 adult patients with CNS brucellosis from 26 referral centers and reviewed their 242 magnetic resonance imaging (MRI) and 226 computerized tomography (CT) scans of the brain.
RESULTS: A normal CT or MRI scan was seen in 143 of 263 patients (54.3 %). Abnormal imaging findings were grouped into the following four categories: (a) inflammatory findings: leptomeningeal involvements (44), basal meningeal enhancements (30), cranial nerve involvements (14), spinal nerve roots enhancement (8), brain abscesses (7), granulomas (6), and arachnoiditis (4). (b) White-matter involvement: white-matter involvement (32) with or without demyelinating lesions (7). (c) Vascular involvement: vascular involvement (42) mostly with chronic cerebral ischemic changes (37). (d) Hydrocephalus/cerebral edema: hydrocephalus (20) and brain edema (40). On multivariate logistic regression analysis duration of symptoms since the onset (OR 1.007; 95 % CI 1-28, p = 0.01), polyneuropathy and radiculopathy (OR 5.4; 95 % CI 1.002-1.013, p = 0.044), cerebrospinal fluid (CSF)/serum glucose rate (OR 0.001; 95 % CI 000-0.067, p = 0.001), and CSF protein (OR 2.5; 95 % CI 2.3-2.7, p = 0.0001) were associated with diffuse inflammation.
CONCLUSIONS: In this study, 45 % of neurobrucellosis patients had abnormal neuroimaging findings. The duration of symptoms, polyneuropathy and radiculopathy, high CSF protein level, and low CSF/serum glucose rate were associated with inflammatory findings on imaging analyses.