Type:
Educational Exhibit
Keywords:
Inflammation, Infection, Acute, Imaging sequences, Diagnostic procedure, Contrast agent-intravenous, MR, CT, Neuroradiology brain, Emergency, CNS
Authors:
R. Silini1, C. Fink2; 1Celle/DE, 2Mannheim/DE
DOI:
10.26044/ecr2019/C-0018
Findings and procedure details
The imaging gold standard in suspected encephalitis is MRI.
Invariably MRI demonstrates brain edema in the affected region.
Diffusion restriction may be present or not.
Gadolinium-Enhancement is usually absent early in the disease but may occur later due to breakdown of the blood brain barrier.
Thus,
repeating the exam may be useful in some cases Fig.
1.
It is important to study the distribution of the lesions,
which can be helpful in the etiologic approach.
For example the involvement of the temporal lobe is typical / pathognomonic of herpes-simplex-encephalitis Fig.
2.
Another approach is very important,
which is the symmetrical aspect of the lesion.
Rare are encephalitides with symmetrical lesions.
It makes the etiologic diagnostic easier by limiting the number of diseases to evocate Fig.
3.