Postcontrast fluid-attenuated inversion recovery (FLAIR) Sequence MRI in infectious meningitis

Early diagnosis of infectious meningitis is essential due to high morbidity and mortality of this disease. Contrast enhanced (CE) magnetic resonance imaging (MRI) has been increasingly used as a non-invasive diagnostic tool and it is also recommended as a first line diagnostic examination in brain infections. Leptomeningeal disease can be more easily visualized on CE fluid-attenuated inversion recovery (FLAIR) images than on CE T1-weighted images because FLAIR imaging allows a clearer distinction between enhancing meninges and enhancing cortical veins, resulting the latter hypointense on CE-FLAIR images. CE-FLAIR sequence should be included as a routine sequence in suspected cases of meningitis.