脑炎影像改变

脑炎影像Herpesencephalitiswithsubsequenthemorrhage.Axialfluidattenuatedinversionrecoveryimage(A)demonstratesaregionofincreasedsignalintensityintherighttemporallobeinthisimmunosuppressedpatient(arrow).AxialT1precontrastimages(B,C)performed3weeksapart(CisafterB)demonstratecurvilinearregionsofhighT1signalintensitywithintherighttemporallobe(arrow,C),compatiblewithpetechialhemorrhageinthispatientwithherpesencephalitis.Varicella-zostervirusencephalitiswithmultifocalvasculopathy.Axialfluidattenuatedinversionrecovery(FLAIR)(A)andT2-weightedimage(B)demonstratehighFLAIRsignalintheleftcaudatenucleusandintheposteriorlimboftheinternalcapsuleaswellashyperintenseT2signalalongtherightparamedianfrontallobe.Magneticresonaneangiogram(C)demonstratesirregularnarrowingintheleftproximalmiddlecerebralandrightanteriorcerebralartery.(ReproducedfromSnooketal.,2003.)WestNileencephalitis.Axialfluidattenuatedinversionrecoveryimages(A,B)demonstrateincreasedsignalinthethalamiandcorpusstriatum.Increasedsignalintensityisalsonotedinthemedialtemporallobesandcerebellum(curvedarrow,B).AxialT1postcontrastimage(C)demonstratesenhancementinthethalami.(ReproducedfromArslanogluetal.,2003.)Japaneseencephalitis.AxialfluidattenuatedinversionrecoveryimagesintwodifferentpatientswithJapaneseencephalitisdemonstratebilateralsymmetricincreasedsignalintensity(A)andasymmetricrightthalamussignalabnormality(B)respectively.(ReproducedfromMisraetal.,2010.)Epstein–Barrvirus.Axialfluidattenuatedinversionrecovery(A)imagingdemonstratesabnormalincreasedsignalintherighttemporallobe.AxialT2-weightedimage(B)performed3dayslaterdemonstratesprogressionofabnormalsignalintherighttemporallobe.Anon-contrastCTscan(C)performedthesamedaydemonstratespartialhemorrhagicconversionofthelesionwithadjacentswellingandright-to-leftmidlineshift.(ReproducedfromTakeuchietal.,2010.)(A,B)Inuterocytomegalovirus(CMV)infection.Coronaltrueinversionrecoveryimagedemonstratesthickenedanddisorderedcortexintherightfrontalandtemporallobes(arrows)compatiblewithpachygyriainthisinfantwithinuteroCMVinfection.

Axialnon-contrastcomputedtomographyscanoftheheaddemonstratesmassivehydrocephalusaswellasbilateralperiventricularcalcificationsinthisinfantwithinuteroCMVinfectionDenguefever.Axialfluidattenuatedinversionrecovery(A)andT2-weighted(B)imagesdemonstratebilateralsymmetricincreasedsignalwithinthehippocampibilaterallyinthispatientwithpositiveantidengueimmunoglobulinG(IgG)andIgMcerebrospinalfluidserologies.(ReproducedfromGuptaetal.,2008.)Chikungunyafever.AxialT2andT1non-contrastimages(A,B)demonstratediffuse,symmetricareaofincreasedT2signalinthecorpuscallosumaswellastheperiventricularandsubcorticalwhitematter.Areasofhemorrhagearenotedinbothcerebralhemispheres,asmanifestedbyareaofdarkT2andbrightT1-weightedsignalintensity(arrows).(ReproducedfromDasetal.,2010.)LaCrosseencephalitis.Axialfluidattenuatedinversionrecoveryimagedemonstratesmultipleregionsofincreasedsignalintensityinvolvingthefrontotemporallobesbilaterally,aswellastheleftinsularcortexandmediallefttemporallobe.Theimagingfindingsareindistinguishablefromherpesencephalitis;however,serologiesconfirmedthepresenceofLaCrossevirus.(ReproducedfromSokoletal.,2001.)Hendravirusencephalitis(A,B).AxialT2-weightedimages(Bperformed1weekafterA)demonstraterapidprogressionofhyperintensesignalprimarilyinvolvingthecortexofbothcerebralhemipsheresbilaterally.(ReproducedfromO’Sullivanetal.,1997.)Nipahvirusencephalitis.Axial