Related Experiment Videos
MR imaging features of Nipah encephalitis
S A Sarji1, B J Abdullah, K J Goh
1Department of Radiology, University of Malaya Medical Center, Jalan Universiti, Malaysia.
Objective:
The newly discovered Nipah virus causes an acute febrile encephalitic illness in humans that is associated with a high mortality. The purpose of this study is to describe the MR imaging findings of Nipah encephalitis.
Materials And Methods:
MR imaging of the brain was performed in 31 patients with Nipah encephalitis divided into three groups. The first group (14 patients) underwent MR imaging during the acute phase of the illness and the second group (10 patients) during the later phase of the acute illness. The third group consisted of six patients who underwent MR imaging because they experienced neurologic relapse and one patient who had late-onset encephalitis. Spin-echo T1- and T2-weighted sequences and T2-weighted fluid attenuated inversion recovery (FLAIR) sequences were performed. Contrast-enhanced MR imaging was performed in four patients.
Results:
The FLAIR sequences revealed abnormalities in all patients studied. MR imaging findings in both the acute and later phases of encephalitis were similar; the main feature of both phases was the presence of discrete high-signal-intensity lesions, measuring 2-7 mm, disseminated throughout the brain, mainly in the subcortical and deep white matter of the cerebral hemispheres. Neither mass effect nor cerebral edema was seen. There was no correlation with the focal neurologic signs, depth of coma, and outcome of the patients. The lesions were attributed to widespread microinfarctions from underlying vasculitis of cerebral small vessels. Features found on MR imaging in relapsed and late-onset encephalitis differed from the features in acute encephalitis in that confluent cortical involvement was the prominent finding in the former, as opposed to discrete focal lesions in the subcortical and deep white matter in the latter.
Conclusion:
MR imaging is a sensitive and specific diagnostic tool for evaluating Nipah encephalitis.
Insights
Nipah virus encephalitis, a severe illness, shows characteristic brain lesions on MR imaging. These findings are crucial for diagnosing this potentially fatal condition.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Nipah virus causes severe, acute febrile encephalitic illness with high mortality.
- Understanding the neuroimaging manifestations of Nipah encephalitis is critical for diagnosis and management.
Purpose of the Study:
- To detail the magnetic resonance (MR) imaging findings in patients diagnosed with Nipah encephalitis.
Main Methods:
- MR imaging of the brain was conducted on 31 patients with Nipah encephalitis, categorized into acute, later acute, and relapsed/late-onset groups.
- Standard spin-echo T1- and T2-weighted, and T2-weighted FLAIR sequences were utilized.
- Contrast-enhanced MR imaging was performed in a subset of patients.
Main Results:
- FLAIR sequences identified abnormalities in all patients, primarily discrete, high-signal-intensity lesions (2-7 mm) in the subcortical and deep white matter.
- Lesion characteristics were similar in acute and later phases, with no mass effect or edema observed.
- Relapsed and late-onset cases showed confluent cortical involvement, distinct from the focal white matter lesions in acute encephalitis.
Conclusions:
- MR imaging is a sensitive and specific diagnostic modality for Nipah encephalitis.
- Imaging findings suggest widespread microinfarctions due to vasculitis as the underlying pathology.