Multiparameter magnetic resonance imaging in the diagnosis of herpes encephalitis in children

Abstract

Introduction. This study is determined with the high prevalence of encephalitis in children, as well as the severe course and the possible disability. Herpes encephalitis occurs in almost half of cases of viral encephalitis in children. It is known that changes on the brain magnetic resonance imaging (MRI) in the acute stage of the disease are detected more often than on brain computed tomography (CT), but the clarification of this brain MRI changes is needed.Objectives of the study. To assess the features of brain multiparametric MRI changes in herpes encephalitis in children.Materials and methods. Two groups of children were examined, the first group included 25 children aged 6,0±4,8 years with laboratory-confirmed acute EH, the second group (control) — 23 children without signs of central nervous system damage at the comparable gender and age. Structural changes were assessed using MRI of the brain in T1-WI, T2-WI, Flair, T1-WI modes post contrast, DWI, DTI and MR spectroscopy.Results. In 40% of cases revealed panencephalitis, 36% — leukoencephalitis, 24% — polioencephalitis. Most often, the process involved the cerebral hemispheres — 72%, the brain stem — 44%, the thalamus — 40% and basal nuclei — 36%. In 52% of cases changes in DWI were found, in 20% of cases the lesions accumulated contrast agent. There was a statistically significant decrease of FA both in the focus and in the intact area in children with EH compared with the control group.Conclusion. The application of multiparametric MRI using DWI, DTI, and MR spectroscopy methods are statistically significant for the detection and assessment of focal brain lesions in children with herpes encephalitis.