West Nile Virus: Case Report with MR Imaging Findings
Humberto Rosasa,b and
Franz J. Wippold, IIa,b,c
a Mallinckrodt Institute of Radiology at Washington University Medical Center, St. Louis, MO
b Department of Radiology, Barnes-Jewish Hospital, St. Louis, MO
c Department of Radiology/Nuclear Medicine, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD
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FIG 1. Images from the case of a 54-year-old woman with serologically proved West Nile virus encephalitis.
A, Unenhanced CT scan of the brain shows subtle bilateral swelling of the basal ganglia and thalami manifested by symmetric hypoattenuation and loss of the anatomic definition of these structures.
B, Unenhanced axial spin-echo T1-weighted MR image (560/17 [TR/TE]) shows uniformly isointense basal ganglia and thalami without the usual anatomic definition of these structures.
C, Axial fast spin-echo T2-weighted MR image (3840/99) shows bilateral hyperintensity of the caudate nuclei, putamina, and thalami. The left side is more involved than the right side, and the globus pallidi are relatively spared.
D, Axial fluid-attenuated inversion recovery MR image (9999/119; inversion time, 2389 ms) reveals bilateral markedly hyperintense basal ganglia and thalami, predominantly on the left side.
E, Contrast-enhanced axial T1-weighted MR image (560/17) fails to show enhancement of the deep gray matter structures.
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