PMC5420411_01
(a-b) Admission brain MRI; (c-d) follow-up brain MRI three weeks later. (a) Contrast-enhanced (CE) axial transverse fluid-attenuated inversion-recovery (FLAIR) view at admission showing diffuse abnormal enhancement of ependyma (white arrow) and bilateral fluid-fluid level at trigonal areas of lateral ventricles (black arrow). (b) Admission diffusion-weighted (DW) axial transverse view at admission at similar slice location as in (a) showing high signal intensity within declive sediment of the fluid-fluid level featuring pus with free water diffusivity restriction (dotted arrows). (c) CE FLAIR view in similar slice location as in (a) three weeks later showing complete subsidence of ependymal contrast-enhancement (white arrow) and disappearance of the fluid-fluid levels (black arrow). Only persistent enhanced brightness of ependymal lining was seen. (d) DW image in similar slice location as in (b) showing only minimal purulent residue within left ventricular trigone (dotted arrow).
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fig1
(a) MIP (maximum intensity projection) of FDG PET showing multiple areas of hypermetabolic activity corresponding to disseminated foci of infection and (b) transaxial views of CT, fused FDG PET-CT and FDG PET images representative of several foci of infection disseminated in joints, soft tissues, and lumbar column (arrows).
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fig2
FDG PET-CT revealed multiple areas of hypermetabolic activity in joints, soft tissues, and spine corresponding to disseminated infection (Figure 2).