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MRI of herpes simplex encephalitis.

P Demaerel1, G Wilms, W Robberecht

  • 1Department of Radiology, University Hospitals K.U. Leuven, Belgium.

Neuroradiology
|January 1, 1992
PubMed
Summary

Magnetic resonance imaging (MRI) offers superior visualization of herpes simplex meningoencephalitis, particularly temporal lobe involvement and hemorrhagic changes. MRI is the preferred diagnostic tool for herpes simplex encephalitis, aiding in diagnosis and patient follow-up.

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Area of Science:

  • Neurology
  • Radiology
  • Infectious Diseases

Background:

  • Herpes simplex virus is a common cause of sporadic fatal encephalitis.
  • Accurate and timely diagnosis of herpes simplex encephalitis is crucial for effective treatment.
  • Conventional neuroimaging modalities have limitations in detecting subtle disease manifestations.

Purpose of the Study:

  • To evaluate the utility of magnetic resonance imaging (MRI) in diagnosing herpes simplex meningoencephalitis (HSME).
  • To compare MRI findings with computed tomography (CT) in HSME patients.
  • To explore the role of MR spectroscopy in assessing neuronal injury.

Main Methods:

  • Retrospective review of MRI examinations in eight patients diagnosed with HSME.
  • Analysis of 14 MRI examinations, correlating findings with clinical data.

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  • Comparison of MRI findings with CT scans where available.
  • Inclusion of localized 1H MR spectroscopy data for selected patients.

    • Main Results:

    • High signal intensity in the temporal lobes was the most consistent MRI finding.
    • Meningeal enhancement was observed in four patients following contrast administration (Gd-DTPA).
    • MRI demonstrated hemorrhagic changes more effectively than CT.
    • Adequate motion control enhanced MRI's diagnostic capability.

    Conclusions:

    • MRI is the imaging modality of choice for diagnosing and monitoring herpes simplex encephalitis due to its superior sensitivity.
    • MRI effectively detects temporal lobe abnormalities, meningeal enhancement, and hemorrhagic changes characteristic of HSME.
    • Localized 1H MR spectroscopy shows potential for evaluating neuronal loss in HSME.