PT - JOURNAL ARTICLE AU - R. Li AU - P.-A. Shi AU - T.-F. Liu AU - Y. Li AU - Y. Wang AU - K. Wu AU - X.-J. Chen AU - H.-F. Xiao AU - Y.-L. Wang AU - L. Ma AU - X. Lou TI - Role of 3D Pseudocontinuous Arterial Spin-Labeling Perfusion in the Diagnosis and Follow-Up in Patients with Herpes Simplex Encephalitis AID - 10.3174/ajnr.A6279 DP - 2019 Nov 01 TA - American Journal of Neuroradiology PG - 1901--1907 VI - 40 IP - 11 4099 - http://www.ajnr.org/content/40/11/1901.short 4100 - http://www.ajnr.org/content/40/11/1901.full SO - Am. J. Neuroradiol.2019 Nov 01; 40 AB - BACKGROUND AND PURPOSE: Early diagnosis and treatment of herpes simplex encephalitis are crucial to reduce morbidity and mortality. Our aim was to investigate the role of 3D pseudocontinuous arterial spin-labeling in herpes simplex encephalitis.MATERIALS AND METHODS: From 2014 to 2019, seventeen consecutive patients with herpes simplex encephalitis and 15 healthy volunteers were recruited in the study. Conventional MR imaging and 3D pseudocontinuous arterial spin-labeling were performed in all subjects. According to the disease duration, the lesions were classified into 3 groups, including acute, subacute, and chronic stages, respectively. Clinical, neuroradiologic, and follow-up features were studied. The normalized lesion/normal tissue CBF values of lesions at different stages were measured and compared with those in the control group, respectively.RESULTS: Compared with the control group, herpes simplex encephalitis demonstrated hyperperfusion in 11 acute cases and 6 subacute cases and hypoperfusion in 6 chronic cases. The mean normalized lesion/normal tissue CBF values of the lesions were 2.68 ± 0.54 in the acute stage, 2.42 ± 0.52 in the subacute stage, and 0.87 ± 0.30 in the chronic stage, respectively. The mean normalized lesion/normal tissue CBF values of acute and subacute lesions were significantly higher than those of the control group (1.33 ± 0.08; P < .001, respectively), while the mean normalized lesion/normal tissue CBF values of chronic lesions were lower than those of the control group (P < .05). Gradual perfusion reduction on serial 3D pseudocontinuous arterial spin-labeling was observed in herpes simplex encephalitis after effective therapy.CONCLUSIONS: Conventional MR imaging remains most helpful in the diagnosis of herpes simplex encephalitis, while 3D pseudocontinuous arterial spin-labeling could be an adjunctive technique by providing dynamic CBF features at different stages in herpes simplex encephalitis.ASLarterial spin-labeling3D-pCASL3D pseudocontinuous ASLHSEherpes simplex encephalitisHSVherpes simplex virusMELASmitochondrial encephalopathy with lactic acidosis and stroke-like episodesnCBFnormalized lesion/normal tissue CBF