Proton MR CSF analysis and a new software as predictors for the differentiation of meningitis in children
| Autor: | Sudhir Kumar Mandal, Abhishek Gupta, Raja Roy, Anjali Nigam, Rashmi Kumar, A Subramanian, Ashish Gupta, Raj Kumar, Swapnil Saxena |
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| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty Pathology Magnetic Resonance Spectroscopy Metabolite Creatine Sensitivity and Specificity Gastroenterology Tuberculous meningitis Diagnosis Differential chemistry.chemical_compound Cerebrospinal fluid Internal medicine medicine Viral meningitis Humans Meningitis Radiology Nuclear Medicine and imaging Diagnosis Computer-Assisted Child Spectroscopy Creatinine business.industry Reproducibility of Results medicine.disease chemistry Child Preschool Multivariate Analysis Molecular Medicine Female Protons Differential diagnosis business Algorithms Biomarkers Software |
| Zdroj: | NMR in Biomedicine. 18:213-225 |
| ISSN: | 1099-1492 0952-3480 |
| Popis: | This article describes proton MR spectroscopic analysis of cerebrospinal fluid of 167 children suffering from meningitis and 24 control cases. Quantification of 12 well-separated and commonly observed cerebrospinal fluid metabolites viz., beta-hydroxybutyrate, lactate, alanine, acetate, acetone, acetoacetate, pyruvate, glutamine, citrate, creatine/creatinine, glucose (total) and urea was carried out using Bruker's NMRQUANT software with respect to a known concentration of sodium-3-(trimethylsilyl)-2,2,3,3-d4-propionate (TSP), serving as an external reference. The assignment of urea in CSF is reported for the first time by NMR. The presence of cyclopropane, observed for the first time in tuberculous meningitis overall in 85.1% of cases, acts as a finger-print marker for the differential diagnosis. Multivariate discriminant function analysis was carried out for the proton MR-detected metabolite information and the clinical symptoms data of the meningitis and control cases to find the important descriptors for classification, followed by a re-validation of the entire database. It was found that the control could be differentiated from the disease group with a success rate of 96.4%, followed by the differential diagnosis of tuberculous meningitis with a corresponding value of 77.2%. Excluding the presence of cyclopropane, bacterial meningitis could be classified 84.4% correct and viral meningitis with a rate of 83.3%. It is proposed that the NMR spectroscopic information, along with other routine clinical features, may serve as an additional diagnostic tool for the differential diagnosis of meningitis in children. |
| Databáze: | OpenAIRE |
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