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American Journal of Neuroradiology, Vol 18, Issue 3 465-469, Copyright © 1997 by American Society of Neuroradiology


ARTICLES

Single-photon emission CT findings in acute Japanese encephalitis

K Kimura, A Dosaka, Y Hashimoto, T Yasunaga, M Uchino and M Ando
Department of Cerebrovascular Disease, Kumamoto City Hospital, Japan.

PURPOSE: To determine the usefulness of single-photon emission CT (SPECT) in the diagnosis of acute Japanese encephalitis (JE). METHODS: We examined 10 patients (six men and four women; mean age, 69 years) with viral encephalitis. We divided the cases into two groups: the JE group (n = 4) and the non-JE group (n = 6; two with herpes simplex encephalitis and four with encephalitis of unknown origin). All cases were investigated with 99mTc-hexamethylpropyleneamine oxime (HMPAO) SPECT within 15 days after the onset of symptoms. Two patients in the JE group were also examinated by SPECT at a later stage. In all cases MR imaging was performed after the SPECT study. RESULTS: In the acute stage, all patients in the JE group showed a marked increase of HMPAO uptake that matched the hyperintense area observed on MR images in the thalami and putamina bilaterally. Follow-up SPECT studies of two patients with JE revealed a decrease of HMPAO deposition in the areas of high uptake. None of the patients in the non-JE group had an increased accumulation of HMPAO in the thalami or the putamina. CONCLUSIONS: SPECT is helpful in differentiating JE from herpes simplex encephalitis and other types of encephalitis. SPECT may be useful as a diagnostic tool in the early stages of JE.


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