PURPOSE: To report the serial magnetic resonance (MR) imaging findings of the Nipah virus. MATERIALS AND METHODS: Twelve patients underwent serial MR imaging. Eight patients were examined at the outbreak; 11, at 1 month; and seven, at 6 months. Contrast material-enhanced MR images, diffusion-weighted images, and single-voxel proton MR spectroscopic images were reviewed. Clinical and neurologic assessment, as well as analysis of the size, location, and appearance of brain lesions on MR images, were performed. RESULTS: During the outbreak, all eight patients had multiple small foci of high signal intensity within the white matter on T2-weighted images. In six patients, cortical and brain stem lesions were also detected, and five patients had diffusion-weighted MR imaging-depicted hyperintensities. One month after the outbreak, five patients had widespread tiny foci of high signal intensity on T1-weighted images, particularly in the cerebral cortex. Diffusion-weighted images showed decreased prominence or disappearance of lesions over time. There was no evidence of progression or relapse of the lesions at 6-month follow-up. MR spectroscopy depicted reduction in N-acetylaspartate-to-creatine ratio and elevation of choline-to-creatine ratios. CONCLUSION: The Nipah virus has findings unlike other viral encephalitides: small lesions that are primarily within the white matter, with transient punctate cortical hyperintensities on T1-weighted images.
PURPOSE: To report the serial magnetic resonance (MR) imaging findings of the Nipah virus. MATERIALS AND METHODS: Twelve patients underwent serial MR imaging. Eight patients were examined at the outbreak; 11, at 1 month; and seven, at 6 months. Contrast material-enhanced MR images, diffusion-weighted images, and single-voxel proton MR spectroscopic images were reviewed. Clinical and neurologic assessment, as well as analysis of the size, location, and appearance of brain lesions on MR images, were performed. RESULTS: During the outbreak, all eight patients had multiple small foci of high signal intensity within the white matter on T2-weighted images. In six patients, cortical and brain stem lesions were also detected, and five patients had diffusion-weighted MR imaging-depicted hyperintensities. One month after the outbreak, five patients had widespread tiny foci of high signal intensity on T1-weighted images, particularly in the cerebral cortex. Diffusion-weighted images showed decreased prominence or disappearance of lesions over time. There was no evidence of progression or relapse of the lesions at 6-month follow-up. MR spectroscopy depicted reduction in N-acetylaspartate-to-creatine ratio and elevation of choline-to-creatine ratios. CONCLUSION: The Nipah virus has findings unlike other viral encephalitides: small lesions that are primarily within the white matter, with transient punctate cortical hyperintensities on T1-weighted images.
Authors: Kum Thong Wong; Wun-Ju Shieh; Shalini Kumar; Karim Norain; Wahidah Abdullah; Jeannette Guarner; Cynthia S Goldsmith; Kaw Bing Chua; Sai Kit Lam; Chong Tin Tan; Khean Jin Goh; Heng Thay Chong; Rani Jusoh; Pierre E Rollin; Thomas G Ksiazek; Sherif R Zaki Journal: Am J Pathol Date: 2002-12 Impact factor: 4.307
Authors: Kalliopi A Petropoulou; Steven M Gordon; Richard A Prayson; Paul M Ruggierri Journal: AJNR Am J Neuroradiol Date: 2005-09 Impact factor: 3.825
Authors: Katharine N Bossart; Lin-Fa Wang; Michael N Flora; Kaw Bing Chua; Sai Kit Lam; Bryan T Eaton; Christopher C Broder Journal: J Virol Date: 2002-11 Impact factor: 5.103