Nipah Viral Encephalitis or Japanese Encephalitis? MR Findings in a New Zoonotic Disease
C. C. Tchoyoson Lim
,a,
Yih Yian Sitoha,
Francis Huia,
Kim En Leea,
Brenda S. P. Anga,
Erle Lima,
Winston E. H. Lima,
Helen M. L. Oha,
Paul A. Tambyaha,
Jill S. L. Wonga,
Chai Beng Tana and
Thomas S. G. Cheea
a From the Departments of Neuroradiology (C.C.T.L., Y.Y.S., F.H.) and Neurology (K.E.L., C.B.T.), National Neuroscience Institute; the Department of Infectious Diseases, Communicable Disease Centre (B.S.P.A.) and the Department of Diagnostic Radiology (T.S.G.C.), Tan Tock Seng Hospital; the Departments of Neurology (E.L.) and Diagnostic Radiology (W.E.H.L.), Singapore General Hospital; the Department of Medicine, Changi General Hospital (H.M.L.O.); and the Departments of Medicine (P.A.T.) and Radiology (J.S.L.W.), National University Hospital, Singapore.
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FIG 1. Patient 1.
A, Multiple punctate white matter lesions (arrowheads) are visible on T2-weighted FSE MR image (4000/105).
B, The largest lesion is more prominent on corresponding diffusion-weighted image (10,000/105; b = 1000).
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FIG 2. Patient 6.
A and B, Proton density–weighted (A) and T2-weighted FSE (3800/22,90) (B) MR images at different levels show innumerable small lesions scattered throughout the white matter bilaterally.
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FIG 3. Patient 5.
A, T2-weighted MR image (4000/105) shows a lesion in the corpus callosum (arrowhead) and several smaller punctate hyperintensities (arrows).
B, Only the larger lesion in the corpus callosum is visible on corresponding diffusion-weighted image (10,000/105; b = 1000).
C, Axial contrast-enhanced T1-weighted image (540/14) shows several foci of enhancement (arrows).
D, Hyperintensities are seen in the pons and cerebellar peduncle (arrows) on T2-weighted image.
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FIG 4. Patient 8.
A, Cortical hyperintensity (arrow) is poorly seen on this degraded T2-weighted MR image (5400/99).
B, The lesion (arrow) is much better visualized on FLAIR image (9000/110; TI=2500).
C, Coronal contrast-enhanced image (665/20) shows gyriform enhancement in the parietal cortex (arrow).
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