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MRI in Japanese encephalitis
1Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Abstract:
We document the MRI features in seven patients with Japanese encephalitis. MRI was carried out on a 1.5 T system within 10-60 days of onset. In all the patients MRI revealed bilateral thalamic lesions, haemorrhagic in five. Signal changes were present in the cerebrum in four patients, the midbrain and cerebellum in three each, the pons in two and the basal ganglia in one. The lesions were haemorrhagic in three of the four patients with lesions in the cortex, two of the three with lesions in the midbrain and cerebellum, but the pontine lesions were haemorrhagic in both patients. Spinal cord involvement was seen in one of the three patients who underwent MRI. In two patients MRI was repeated 3 years after the onset, showing marked reduction in abnormal signal; and all the lesions gave low signal on both T1- and T2-weighted images. Bilateral thalamic involvement, especially haemorrhagic, may be considered characteristic of Japanese encephalitis, especially in endemic areas.
Insights
Magnetic resonance imaging (MRI) revealed characteristic bilateral thalamic lesions in Japanese encephalitis patients. Hemorrhagic thalamic lesions on MRI may indicate Japanese encephalitis, particularly in endemic regions.
Area of Science:
- Neurology
- Radiology
- Infectious Diseases
Background:
- Japanese encephalitis is a significant cause of viral encephalitis in Asia.
- Neuroimaging is crucial for diagnosing and understanding the extent of brain involvement.
Purpose of the Study:
- To describe the magnetic resonance imaging (MRI) findings in patients diagnosed with Japanese encephalitis.
- To identify characteristic MRI features that could aid in the diagnosis of this condition.
Main Methods:
- MRI scans were performed on seven patients with confirmed Japanese encephalitis using a 1.5 T system.
- Imaging was conducted between 10 and 60 days post-symptom onset.
- Follow-up MRI was performed in two patients three years after initial diagnosis.
Main Results:
- All seven patients exhibited bilateral thalamic lesions, with five showing hemorrhagic changes.
- Signal abnormalities were also observed in the cerebrum, midbrain, cerebellum, pons, and basal ganglia.
- Follow-up MRI demonstrated a significant reduction in abnormal signals, with lesions appearing low signal on T1- and T2-weighted images.
Conclusions:
- Bilateral thalamic involvement, particularly when hemorrhagic, is a highly suggestive MRI finding for Japanese encephalitis.
- MRI features can help characterize the neurological damage caused by Japanese encephalitis.
- These findings are especially relevant for diagnosis in areas where the disease is endemic.