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MRI and SPECT in influenzal encephalitis
Y Fujii1, M Kuriyama, Y Konishi
1Department of Pediatrics, Fukui Medical School, Japan.
Abstract:
Repeated magnetic resonance imaging studies were performed in a 22-month-old boy with influenzal encephalitis. T2-weighted magnetic resonance images disclosed multifocal hyperintense areas in the cortex and subcortical white matter of the left frontal, temporal, parietal, and right frontal lobes. 123I single photon emission computed tomography (SPECT) brain images demonstrated decreased uptake in the same regions. SPECT revealed larger areas of decreased uptake as compared with magnetic resonance imaging. One year after the onset of encephalitis, these brain lesions continue to be observed, although the patient has no apparent neurologic sequelae.
Insights
Influenzal encephalitis can cause persistent brain lesions, visible on magnetic resonance imaging and iodine-123 single photon emission computed tomography scans. Despite imaging abnormalities, young children may show no long-term neurological deficits.
Area of Science:
- Neurology
- Pediatrics
- Radiology
Background:
- Influenzal encephalitis is a serious neurological complication of influenza infection in children.
- Early diagnosis and monitoring are crucial for managing pediatric encephalitis.
- Magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT) are key neuroimaging modalities.
Observation:
- A 22-month-old boy diagnosed with influenzal encephalitis underwent serial MRI and SPECT brain imaging.
- T2-weighted MRI revealed multifocal hyperintense lesions in the cerebral cortex and subcortical white matter.
- Iodine-123 SPECT demonstrated decreased radiotracer uptake in corresponding brain regions.
Findings:
- MRI identified lesions in the left frontal, temporal, parietal, and right frontal lobes.
- SPECT revealed a larger extent of compromised brain regions compared to MRI.
- These imaging abnormalities persisted one year post-encephalitis onset.
Implications:
- SPECT may detect more extensive functional deficits than MRI in influenzal encephalitis.
- Persistent neuroimaging findings do not always correlate with long-term neurological sequelae in children.
- This case highlights the importance of multimodal neuroimaging in assessing pediatric encephalitis.