MR Imaging in Human Rabies
Jiraporn Laothamatasa,
Thiravat Hemachudhac,
Erawady Mitrabhakdic,
Pongsak Wannakrairota,b,c,d and
Supoch Tulayadaechanontb,d
a Department of Radiology, Ramathibodi Hospital, Bangkok
b Department of Medicine, Ramathibodi Hospital, Bangkok
c Department of Medicine, Chulalongkorn Hospital, Bangkok, Thailand
d Department of Pathology, Chulalongkorn Hospital, Bangkok, Thailand
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FIG 1. Patient 1. Encephalitic rabies.
A and B, Coronal fast spin-echo T2-weighted MR images of the brain, and C and D, axial gradient-echo T2-weighted MR images of the cervical cord. A and C were obtained on day 3 and B and D on day 7 after clinical onset. Note slight progression of an ill-defined mild hyperintensity change involving the deep and subcortical white matter (arrow with block in A and double arrows in B), hippocampal gyri (black arrow with circle in A and B), brain stem (arrowhead in A and B), and cervical cord (arrow in C and D).
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FIG 2. Patient 2. Encephalitic rabies.
A and B, Axial fast spin-echo T2-weighted MR images of the brain, after the patient received intravenous HRIG, demonstrate ill-defined hyperintensity changes involving the brain stem (arrow in A), both deep and cortical gray matter (arrowheads in B), and deep and subcortical white matter (arrow with block in B).
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FIG 3. Patient 1. Encephalitis rabies.
A, Coronal and B, axial gadolinium-enhanced T1-weighted fat-suppressed MR images of the brachial plexi, and C, axial gadolinium-enhanced T1-weighted image of the cervical spine reveal ill-defined, mild to moderate enhancement along the left brachial plexus (arrows in A and B) and intradural left dorsal cervical nerve root (arrows in C).
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FIG 4. Patient 4. Paralytic rabies.
A, Coronal and B, axial fast spin-echo T2-weighted images of the brain reveal ill-defined mild hyperintensity change at the posterior right paramedian lower medulla and hippocampi (arrowhead in A and B) and deep white matter of the brain (double arrows in A).
C, Axial and D and E, sagittal gadolinium-enhanced T1-weighted images of the hypothalami, brain stem, and upper cervical cord demonstrate mild to moderate enhancement at the hypothalami (arrow with circle in C and double arrow in D), tectal plate (thick arrow in C and D), periaqueductal gray matter (arrowhead in D), pons and medulla (arrows with block in D), and cervical cord (arrows in E). There is no meningeal enhancement. (Reprinted with permission from reference 3.)
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FIG 5. Patient 5. Paralytic rabies.
A, Coronal and B, axial fast spin-echo T2-weighted images of the brain, and C, gadolinium-enhanced axial T1-weighted image of the midcervical cord reveal ill-defined moderate hyperintensity changes of the deep gray matter (double arrows in A), white matter (single arrow in A), and brain stem and dentate nuclei (arrowhead and arrow with block in B). Vivid enhancement of the ventral and dorsal cervical nerve roots (arrows in C) is demonstrated. (Reprinted with permission from reference 3.)
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