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CT and MR neuroimaging findings in patients with Lyme neuroborreliosis: A national prospective cohort study

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Harvard

Ørbæk, M, Bodilsen, J, Gynthersen, RMM, Shekhrajka, N, Nordberg, CL, Larsen, L, Storgaard, M, Brandt, C, Wiese, L, Hansen, BR, Luttichau, HR, Andersen, AB, Mens, H, Nielsen, H, Lebech, A-M & DASGIB study group 2020, 'CT and MR neuroimaging findings in patients with Lyme neuroborreliosis: A national prospective cohort study', Journal of the Neurological Sciences, bind 419, 117176, s. 117176. https://doi.org/10.1016/j.jns.2020.117176

APA

Ørbæk, M., Bodilsen, J., Gynthersen, R. M. M., Shekhrajka, N., Nordberg, C. L., Larsen, L., Storgaard, M., Brandt, C., Wiese, L., Hansen, B. R., Luttichau, H. R., Andersen, A. B., Mens, H., Nielsen, H., Lebech, A-M., & DASGIB study group (2020). CT and MR neuroimaging findings in patients with Lyme neuroborreliosis: A national prospective cohort study. Journal of the Neurological Sciences, 419, 117176. [117176]. https://doi.org/10.1016/j.jns.2020.117176

CBE

Ørbæk M, Bodilsen J, Gynthersen RMM, Shekhrajka N, Nordberg CL, Larsen L, Storgaard M, Brandt C, Wiese L, Hansen BR, Luttichau HR, Andersen AB, Mens H, Nielsen H, Lebech A-M, DASGIB study group. 2020. CT and MR neuroimaging findings in patients with Lyme neuroborreliosis: A national prospective cohort study. Journal of the Neurological Sciences. 419:117176. https://doi.org/10.1016/j.jns.2020.117176

MLA

Vancouver

Author

Ørbæk, Mathilde ; Bodilsen, Jacob ; Gynthersen, Rosa M Møhring ; Shekhrajka, Nitesh ; Nordberg, Cecilie Lerche ; Larsen, Lykke ; Storgaard, Merete ; Brandt, Christian ; Wiese, Lothar ; Hansen, Birgitte Rønde ; Luttichau, Hans R ; Andersen, Aase Bengaard ; Mens, Helene ; Nielsen, Henrik ; Lebech, Anne-Mette ; DASGIB study group. / CT and MR neuroimaging findings in patients with Lyme neuroborreliosis : A national prospective cohort study. I: Journal of the Neurological Sciences. 2020 ; Bind 419. s. 117176.

Bibtex

@article{9abf9634fd43456cab86250a9902ae06,
title = "CT and MR neuroimaging findings in patients with Lyme neuroborreliosis: A national prospective cohort study",
abstract = "BACKGROUND: We aimed to describe the use and findings of cranial computerized tomography (CT-head), spine and brain magnetic resonance imaging (MRI-spine/MRI-brain) in Lyme neuroborreliose (LNB).METHODS: Patients with LNB were identified using a nationwide, population-based prospective cohort of all adults treated for neuroinfections at departments of infectious diseases in Denmark from 2015 to 2019. Multivariate logistic regression analyses assessed associations between clinical characteristics and MRI-findings consistent with LNB.RESULTS: We included 368 patients (272 definite LNB and 96 probable LNB), 280 scans were performed in 198 patients. Neuroimaging was associated with older age (59 vs. 57, p = 0.03), suspicion of other diseases (77% vs. 37%, p < 0.0001), no history of tick bites (58% vs. 43%, p = 0.01), physical/cognitive deficits prior to admission (15% vs 5%, p = 0.006), peripheral palsy (10% vs. 2%, p = 0.0008), encephalitis (8% vs. 1%, p = 0.0007) and cognitive impairment (8% vs. 2%, p = 0.03) compared with those without neuroimaging. Normal or incidental findings were common (93/98 CT-head and 154/182 MRI). 1/98 CT-head, 19/131 MRI-brain and 6/51 MRI-spine had findings consistent with LNB. Symptoms ≥45 days was associated with MRI-findings consistent with LNB (adjusted odds ratio (aOR) 4.2, 95%confidence interval 1.2-14.4, p = 0.02).CONCLUSION: In this Danish cohort including 368 LNB-patients, use of neuroimaging was common and often performed in older comorbid patients without previous tick-bite intended to investigate alternative diagnoses. The results were in general without pathology and neuroimaging cannot exclude LNB or replace lumbar puncture. MRI is of value when investigating alternative neurological diseases and may support suspicion of LNB in cases with meningeal/leptomeningeal/neural enhancement.",
keywords = "Borrelia burgdorferi sensu lato complex, CT, Lyme Neuroborreliosis, MRI, Neuroimaging, Tick-borne diseases",
author = "Mathilde {\O}rb{\ae}k and Jacob Bodilsen and Gynthersen, {Rosa M M{\o}hring} and Nitesh Shekhrajka and Nordberg, {Cecilie Lerche} and Lykke Larsen and Merete Storgaard and Christian Brandt and Lothar Wiese and Hansen, {Birgitte R{\o}nde} and Luttichau, {Hans R} and Andersen, {Aase Bengaard} and Helene Mens and Henrik Nielsen and Anne-Mette Lebech and {DASGIB study group}",
note = "Copyright {\textcopyright} 2020 Elsevier B.V. All rights reserved.",
year = "2020",
month = dec,
day = "15",
doi = "10.1016/j.jns.2020.117176",
language = "English",
volume = "419",
pages = "117176",
journal = "Journal of the Neurological Sciences",
issn = "0022-510X",
publisher = "Elsevier BV",

}

RIS

TY - JOUR

T1 - CT and MR neuroimaging findings in patients with Lyme neuroborreliosis

T2 - A national prospective cohort study

AU - Ørbæk, Mathilde

AU - Bodilsen, Jacob

AU - Gynthersen, Rosa M Møhring

AU - Shekhrajka, Nitesh

AU - Nordberg, Cecilie Lerche

AU - Larsen, Lykke

AU - Storgaard, Merete

AU - Brandt, Christian

AU - Wiese, Lothar

AU - Hansen, Birgitte Rønde

AU - Luttichau, Hans R

AU - Andersen, Aase Bengaard

AU - Mens, Helene

AU - Nielsen, Henrik

AU - Lebech, Anne-Mette

AU - DASGIB study group

N1 - Copyright © 2020 Elsevier B.V. All rights reserved.

PY - 2020/12/15

Y1 - 2020/12/15

N2 - BACKGROUND: We aimed to describe the use and findings of cranial computerized tomography (CT-head), spine and brain magnetic resonance imaging (MRI-spine/MRI-brain) in Lyme neuroborreliose (LNB).METHODS: Patients with LNB were identified using a nationwide, population-based prospective cohort of all adults treated for neuroinfections at departments of infectious diseases in Denmark from 2015 to 2019. Multivariate logistic regression analyses assessed associations between clinical characteristics and MRI-findings consistent with LNB.RESULTS: We included 368 patients (272 definite LNB and 96 probable LNB), 280 scans were performed in 198 patients. Neuroimaging was associated with older age (59 vs. 57, p = 0.03), suspicion of other diseases (77% vs. 37%, p < 0.0001), no history of tick bites (58% vs. 43%, p = 0.01), physical/cognitive deficits prior to admission (15% vs 5%, p = 0.006), peripheral palsy (10% vs. 2%, p = 0.0008), encephalitis (8% vs. 1%, p = 0.0007) and cognitive impairment (8% vs. 2%, p = 0.03) compared with those without neuroimaging. Normal or incidental findings were common (93/98 CT-head and 154/182 MRI). 1/98 CT-head, 19/131 MRI-brain and 6/51 MRI-spine had findings consistent with LNB. Symptoms ≥45 days was associated with MRI-findings consistent with LNB (adjusted odds ratio (aOR) 4.2, 95%confidence interval 1.2-14.4, p = 0.02).CONCLUSION: In this Danish cohort including 368 LNB-patients, use of neuroimaging was common and often performed in older comorbid patients without previous tick-bite intended to investigate alternative diagnoses. The results were in general without pathology and neuroimaging cannot exclude LNB or replace lumbar puncture. MRI is of value when investigating alternative neurological diseases and may support suspicion of LNB in cases with meningeal/leptomeningeal/neural enhancement.

AB - BACKGROUND: We aimed to describe the use and findings of cranial computerized tomography (CT-head), spine and brain magnetic resonance imaging (MRI-spine/MRI-brain) in Lyme neuroborreliose (LNB).METHODS: Patients with LNB were identified using a nationwide, population-based prospective cohort of all adults treated for neuroinfections at departments of infectious diseases in Denmark from 2015 to 2019. Multivariate logistic regression analyses assessed associations between clinical characteristics and MRI-findings consistent with LNB.RESULTS: We included 368 patients (272 definite LNB and 96 probable LNB), 280 scans were performed in 198 patients. Neuroimaging was associated with older age (59 vs. 57, p = 0.03), suspicion of other diseases (77% vs. 37%, p < 0.0001), no history of tick bites (58% vs. 43%, p = 0.01), physical/cognitive deficits prior to admission (15% vs 5%, p = 0.006), peripheral palsy (10% vs. 2%, p = 0.0008), encephalitis (8% vs. 1%, p = 0.0007) and cognitive impairment (8% vs. 2%, p = 0.03) compared with those without neuroimaging. Normal or incidental findings were common (93/98 CT-head and 154/182 MRI). 1/98 CT-head, 19/131 MRI-brain and 6/51 MRI-spine had findings consistent with LNB. Symptoms ≥45 days was associated with MRI-findings consistent with LNB (adjusted odds ratio (aOR) 4.2, 95%confidence interval 1.2-14.4, p = 0.02).CONCLUSION: In this Danish cohort including 368 LNB-patients, use of neuroimaging was common and often performed in older comorbid patients without previous tick-bite intended to investigate alternative diagnoses. The results were in general without pathology and neuroimaging cannot exclude LNB or replace lumbar puncture. MRI is of value when investigating alternative neurological diseases and may support suspicion of LNB in cases with meningeal/leptomeningeal/neural enhancement.

KW - Borrelia burgdorferi sensu lato complex

KW - CT

KW - Lyme Neuroborreliosis

KW - MRI

KW - Neuroimaging

KW - Tick-borne diseases

UR - http://www.scopus.com/inward/record.url?scp=85094571476&partnerID=8YFLogxK

U2 - 10.1016/j.jns.2020.117176

DO - 10.1016/j.jns.2020.117176

M3 - Journal article

C2 - 33130434

VL - 419

SP - 117176

JO - Journal of the Neurological Sciences

JF - Journal of the Neurological Sciences

SN - 0022-510X

M1 - 117176

ER -

ID: 61195928