CT and MRI Findings of Human Herpesvirus 6–Associated Encephalopathy: Comparison With Findings of Herpes Simplex Virus Encephalitis
| Autor: | Takashi Matsuura, Koji Yamashita, Hiroshi Honda, Akira Uchino, Kazushige Atsumi, Akio Hiwatashi, Futoshi Mihara, Sho Kudo, Osamu Togao, Takashi Yoshiura, Eiki Nagao, Toshiro Kuroiwa, Kanehiro Hasuo, Tomoyuki Noguchi |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Gadolinium DTPA Male Pathology medicine.medical_specialty Adolescent Herpesvirus 6 Human viruses Encephalopathy Contrast Media Roseolovirus Infections Comorbidity medicine.disease_cause Temporal lobe Diagnosis Differential Central nervous system disease medicine Humans Radiology Nuclear Medicine and imaging Child Aged biology medicine.diagnostic_test business.industry Viral encephalitis virus diseases Magnetic resonance imaging General Medicine Middle Aged medicine.disease biology.organism_classification Magnetic Resonance Imaging Herpes simplex virus Encephalitis Female Human herpesvirus 6 Encephalitis Herpes Simplex Tomography X-Ray Computed business |
| Zdroj: | American Journal of Roentgenology. 194:754-760 |
| ISSN: | 1546-3141 0361-803X |
| Popis: | It is important to differentiate human herpesvirus 6 (HHV-6)-associated encephalopathy from herpes simplex encephalitis (HSE). Although these conditions are similar with regard to involvement of the mesial temporal lobe, HSE is sensitive to acyclovir but HHV-6 encephalopathy is not. We compared the imaging findings of the two conditions.We encountered eight cases of HHV-6 encephalopathy and nine cases of HSE. We divided an observation time into early, middle, and late periods defined as 0-2, 3-30, and more than 30 days from the onset of neurologic symptoms. Differences between HHV-6 encephalopathy and HSE on CT scans in the early period and in distribution and temporal changes in the affected regions on MR images in the three periods were analyzed.At MRI in the early and middle periods, all eight patients with HHV-6 encephalopathy had exclusive involvement of the mesial temporal lobes, and all nine patients with HSE had involvement of both the mesial temporal lobes and the extratemporal regions (p0.01). Among patients who underwent head MRI, six of six with HHV-6 encephalopathy but none of six with HSE had resolution of high signal intensity on T2-weighted and FLAIR images (p0.01). Among patients who underwent head CT in the early period, none of the four with HHV-6 encephalopathy and six of the seven with HSE had abnormal findings, including parenchymal swelling, decreased attenuation of affected regions, and abnormal gyral enhancement (p0.05).Serial MRI showed transient abnormal signal intensity in the mesial temporal lobes in patients with HHV-6 encephalopathy but persistent abnormal signal intensity in both the mesial temporal lobes and the extratemporal regions in patients with HSE. CT in the early period showed no abnormality in patients with HHV-6 encephalopathy but definite abnormal findings in patients with HSE. These differences may be useful in the differential diagnosis of the two conditions. |
| Databáze: | OpenAIRE |
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