Update on neuroimaging in infectious central nervous system disease

Purpose of reviewNeuroimaging constitutes an important component in the diagnosis of the underlying infectious agents in central nervous system infection. This review summarizes progress in the neuroimaging of infectious central nervous system disease since January 2003. It focuses on imaging of viral encephalitis, including that caused by exotic and emerging viruses, and on imaging in immunodeficient patients. Recent findingsDiffusion-weighted imaging has been shown to be superior to conventional magnetic resonance imaging for the detection of early signal abnormalities in herpes simplex virus encephalitis but also in enterovirus 71 encephalitis and in West Nile encephalitis. Several studies defined the pattern of magnetic resonance imaging signal changes in endemic diseases such as West Nile encephalitis, Murray Valley encephalitis, enterovirus 71 encephalitis and Japanese encephalitis, but also in encephalitides due to ubiquitous viruses such as measles virus and Lyssavirus (rabies). In patients with HIV infection, apparent diffusion coefficient ratios obtained by diffusion-weighted imaging were significantly greater in lesions due to Toxoplasma encephalitis than in primary central nervous system lymphomas. SummaryThe diagnosis of unclear infectious central nervous system diseases remains a challenge. More recent magnetic resonance imaging techniques, such as diffusion-weighted imaging and magnetic resonance spectroscopy, provide additional helpful information. However, the mainstay of diagnosis remains the detection of viral DNA or serological markers of specific infectious agents within the cerebrospinal fluid.

[1]  T. Okudera,et al.  Japanese encephalitis in the Kurume region of Japan: CT and MRI findings , 1989, Journal of Neurology.

[2]  J. Ferrara,et al.  West Nile virus encephalitis causing fatal CNS toxicity after hematopoietic stem cell transplantation , 2004, Bone Marrow Transplantation.

[3]  T. Nägele,et al.  Diffusion-weighted MRI in herpes simplex encephalitis: a report of three cases , 2004, Neuroradiology.

[4]  D. Mikulis,et al.  MR diffusion-weighted imaging in a case of West Nile virus encephalitis , 2003, Neurology.

[5]  G. Tung,et al.  Diffusion-weighted MRI of cerebral toxoplasma abscess. , 2003, AJR. American journal of roentgenology.

[6]  U. Misra,et al.  A comparison of clinical and radiological findings in adults and children with Japanese encephalitis. , 2003, Archives of neurology.

[7]  R. Gingrich,et al.  A fatal case of West Nile virus infection in a bone marrow transplant recipient. , 2003, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[8]  J. Tanabe,et al.  Diffusion-weighted MRI abnormalities as a clue to the diagnosis of herpes simplex encephalitis , 2003, Neurology.

[9]  W. Sanders,et al.  West nile virus encephalitis involving the substantia nigra: neuroimaging and pathologic findings with literature review. , 2003, Archives of neurology.

[10]  U. Klose,et al.  Progressive multifocal leukoencephalopathy: analysis of lesion development with diffusion-weighted MRI , 2003, Neuroradiology.

[11]  H. Kim,et al.  The cerebrovascular response to traditional acupuncture after stroke , 2003, Neuroradiology.

[12]  R. Bouchard,et al.  Fulminating adult-onset subacute sclerosing panencephalitis in a 49-year-old man. , 2003, Archives of neurology.

[13]  J. Slavotinek,et al.  MR findings in Murray Valley encephalitis. , 2003, AJNR. American journal of neuroradiology.

[14]  J. Sejvar,et al.  Neurologic manifestations and outcome of West Nile virus infection. , 2003, JAMA.

[15]  W. Schlote,et al.  Progressive multifocal leucoencephalopathy with unusual inflammatory response during antiretroviral treatment , 2003, Journal of neurology, neurosurgery, and psychiatry.

[16]  S. Günther,et al.  Clinical and laboratory findings on the first imported case of Murray Valley encephalitis in Europe. , 2003, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[17]  T. Yoshikawa,et al.  Human herpesvirus 7‐associated meningitis and optic neuritis in a patient after allogeneic stem cell transplantation , 2003, Journal of medical virology.

[18]  J. Loeb,et al.  Asymmetric flaccid paralysis: A neuromuscular presentation of West Nile virus infection , 2003, Annals of neurology.

[19]  T. Solomon.  Exotic and emerging viral encephalitides. , 2003, Current opinion in neurology.

[20]  P. Wannakrairot,et al.  MR imaging in human rabies. , 2003, AJNR. American journal of neuroradiology.

[21]  M. Nolan,et al.  Survival after pulmonary edema due to enterovirus 71 encephalitis , 2003, Neurology.

[22]  Dae-Yeol Lee,et al.  Neurologic outcome of acute measles encephalitis according to the MRI patterns. , 2003, Pediatric neurology.

[23]  Mauricio Castillo,et al.  Differentiation of toxoplasmosis and lymphoma in AIDS patients by using apparent diffusion coefficients. , 2003, AJNR. American journal of neuroradiology.

[24]  P. Griffiths,et al.  Cytomegalovirus, human herpesvirus-6, and human herpesvirus-7 in hematological patients. , 2003, Seminars in hematology.

[25]  P. Demaerel,et al.  Diffusion-weighted MR imaging findings in a patient with herpes simplex encephalitis. , 2003, European journal of radiology.

[26]  T. Baysal,et al.  Early- and late-state subacute sclerosing panencephalitis: chemical shift imaging and single-voxel MR spectroscopy. , 2003, AJNR. American journal of neuroradiology.

[27]  T. Yoshikawa.  Human herpesvirus‐6 and ‐7 infections in transplantation , 2003, Pediatric transplantation.

[28]  A. Auchus,et al.  Late clinical and magnetic resonance imaging follow up of Nipah virus infection , 2003, Journal of neurology, neurosurgery, and psychiatry.

[29]  Soriul Kim,et al.  Acute encephalitis associated with measles: MRI features , 2003, Neuroradiology.

[30]  Wiley Interscience,et al.  Neuroinvasion during delayed primary HHV‐7 infection in an immunocompetent adult with encephalitis and flaccid paralysis , 2002, Journal of medical virology.

[31]  M. Frings,et al.  Adult-onset subacute sclerosing panencephalitis presenting as a degenerative dementia syndrome , 2002, Journal of Neurology.

[32]  A. Auchus,et al.  Nipah virus encephalitis: serial MR study of an emerging disease. , 2002, Radiology.

[33]  H. Diener,et al.  Progressive multifocal leukoencephalopathy limited to the brain stem , 2002, Neuroradiology.

[34]  D. Gubler,et al.  West Nile encephalitis: an emerging disease in the United States. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[35]  J. Provenzale,et al.  Human herpesvirus 6 limbic encephalitis after stem cell transplantation , 2001, Annals of neurology.

[36]  G. Guaraldi,et al.  Case of fatal encephalitis by HHV‐6 variant A , 2001, Journal of medical virology.

[37]  J. Haselgrove,et al.  Diffusion imaging in pediatric central nervous system infections , 2001, Neuroradiology.

[38]  V. Hinson,et al.  Update on viral encephalitis , 2001, Current opinion in neurology.

[39]  E. Schmutzhard.  Viral infections of the CNS with special emphasis on herpes simplex infections , 2001, Journal of Neurology.

[40]  J. Becker,et al.  HIV-associated neurologic disease incidence changes: , 2001, Neurology.

[41]  C. Lui,et al.  Acute flaccid paralysis in infants and young children with enterovirus 71 infection: MR imaging findings and clinical correlates. , 2001, AJNR. American journal of neuroradiology.

[42]  Nina Singh,et al.  Infections of the central nervous system in transplant recipients , 2000, Transplant infectious disease : an official journal of the Transplantation Society.

[43]  Andreas Hufnagel,et al.  Incidence and prevalence of neurological disorders associated with HIV since the introduction of highly active antiretroviral therapy (HAART) , 2000, Journal of neurology, neurosurgery, and psychiatry.

[44]  Raj Kumar Gupta,et al.  Parkinsonism due to predominant involvement of substantia nigra in Japanese encephalitis. , 1999, Neurology.

[45]  J. Kalita,et al.  Comparison of CT scan and MRI findings in the diagnosis of Japanese encephalitis , 2000, Journal of the Neurological Sciences.

[46]  Rakesh K. Gupta,et al.  Parkinsonism due to predominant involvement of substantia nigra in Japanese encephalitis. , 1999 .

[47]  K. Chow,et al.  MR Imaging Findings of Enteroviral Encephalomyelitis: An Outbreak in Taiwan , 1999 .

[48]  Adeeba Kamarulzaman,et al.  Fatal encephalitis due to Nipah virus among pig-farmers in Malaysia , 1999, The Lancet.

[49]  T. Yeh,et al.  Neurologic complications in children with enterovirus 71 infection. , 1999, The New England journal of medicine.

[50]  H. Diener,et al.  Opportunistic CNS infection after bone marrow transplantation , 1999, Bone Marrow Transplantation.

[51]  K. Chow,et al.  MR imaging findings of enteroviral encephaloymelitis: an outbreak in Taiwan. , 1999, AJNR. American journal of neuroradiology.

[52]  Outbreak of Hendra-like virus--Malaysia and Singapore, 1998-1999. , 1999, Canada communicable disease report = Releve des maladies transmissibles au Canada.

[53]  A. Straube,et al.  Neurological and neuroradiological findings in long‐term survivors of allogeneic bone marrow transplantation , 1998, Annals of neurology.

[54]  R. Gupta,et al.  MRI in Japanese encephalitis , 1997, Neuroradiology.

[55]  P. Cinque,et al.  The role of laboratory investigation in the diagnosis and management of patients with suspected herpes simplex encephalitis: a consensus report. The EU Concerted Action on Virus Meningitis and Encephalitis. , 1996, Journal of neurology, neurosurgery, and psychiatry.

[56]  E. Tolosa,et al.  Neurologic complications of autologous and allogeneic bone marrow transplantation in patients with leukemia , 1996, Neurology.

[57]  M. White,et al.  Fluid attenuated inversion recovery (FLAIR) MRI of herpes encephalitis. , 1995, Journal of computer assisted tomography.

[58]  D. Davis,et al.  Neurologic complications of bone marrow transplantation. , 1988, Neurologic clinics.

[59]  G. Schroth,et al.  Early diagnosis of herpes simplex encephalitis by MRI , 1987, Neurology.

[60]  J. Dupont,et al.  Human rabies encephalitis , 1965, Neurology.