Images in a 50-year-old man with empyema and chronic meningitis.

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Presentation transcript:

Images in a 50-year-old man with empyema and chronic meningitis. Images in a 50-year-old man with empyema and chronic meningitis. MR images in A–C were obtained at the subacute stage (19 days after symptom onset).A, Axial T2-weighted image shows low intensity in subcortical white matter in the left frontoparietal lobe.B, Axial FLAIR image also shows low intensity in the left frontoparietal lobe with high intensity of cortex and sulcus.C, Axial contrast-enhanced T1-weighted image shows prominent enhancement of thickened pachymeninx and leptomeningeal enhancement in the affected hemisphere. Small amount of subdural fluid (arrowheads) is also seen in the left hemisphere.D, Follow-up T2-weighted image obtained 19 days after initial MR examination shows that the subcortical low intensity is markedly decreased. Focal edema is noted in the left frontal lobe; this might be the result of parenchymal injury developed during meningeal biopsy. Histologic examination revealed nonspecific chronic meningeal inflammation (not shown).E, On follow-up contrast-enhanced T1-weighted image, no leptomeningeal enhancement is seen. Jae Hee Lee et al. AJNR Am J Neuroradiol 2002;23:535-542 ©2002 by American Society of Neuroradiology