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Imaging of topographic viral CNS infections

Zoran Rumboldt1

  • 1Department of Radiology, Medical University of South Carolina, 169 Ashley Avenue, Charleston, SC 29425, USA. rumbolz@musc.edu

Neuroimaging Clinics of North America
|March 6, 2008
PubMed

Insights

Brain imaging reveals inflammatory cell infiltration in enterovirus, rabies, adenovirus, Nipah, and Hanta virus infections. Diffusion-weighted MRI excels at detecting early encephalitis abnormalities, while SPECT hyperperfusion predicts poor prognosis.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Enteroviruses, rabies, adenoviruses, Nipah, and Hanta viruses cause significant neurological infections.
  • Parenchymal infiltration by inflammatory cells characterizes these infections on imaging.
  • Conventional CT and MRI show characteristic signal abnormalities.

Purpose of the Study:

  • To review the MR imaging findings in various viral encephalitis.
  • To highlight the utility of advanced MRI techniques and other imaging modalities.

Main Methods:

  • Review of studies detailing MR imaging findings in viral encephalitis.
  • Discussion of CT, conventional MRI, diffusion-weighted MRI, and SPECT findings.
  • Correlation of imaging findings with clinical outcomes.

Main Results:

  • MR imaging findings reflect inflammatory cell infiltration, appearing as low attenuation on CT and low T1/high T2 signals on MRI.
  • Diffusion-weighted MRI is superior to conventional MRI for detecting early encephalitis abnormalities.
  • Focal unilateral hyperperfusion on SPECT indicates severe brain inflammation and predicts poor prognosis, independent of clinical, CSF, or EEG data.

Conclusions:

  • Advanced MRI techniques like diffusion-weighted imaging improve early detection of encephalitis.
  • SPECT-detected hyperperfusion is a significant independent predictor of poor outcomes in viral encephalitis.
  • Imaging plays a crucial role in diagnosing and prognosticating viral brain infections.

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