Investig Magn Reson Imaging.  2016 Dec;20(4):250-253. 10.13104/imri.2016.20.4.250.

An Unusual Case of Japanese Encephalitis Involving Unilateral Deep Gray Matter and Temporal Lobe on Diffusion-Weighted MRI

• Seok HY
• Lee DH

• KMID: 2366407
• DOI: http://doi.org/10.13104/imri.2016.20.4.250

Abstract

Acute Japanese encephalitis (JE) is an endemic viral infectious disease in various parts of Far East and Southeast Asian countries including Korea. Bilateral thalami are the most common involving sites in JE. Other areas including the basal ganglia, substantia nigra, red nucleus, pons, cerebral cortex and cerebellum may be also involved. We report an extremely unusual brain diffusion-weighted MR imaging (DWI) findings in a 53-year-old man with serologically proven JE involving unilateral deep gray matter and temporal lobe, which shows multifocal high signal intensities in left thalamus, left substantia nigra, left caudate nucleus and left medial temporal cortex on T2-weighted image and DWI with iso-intensity on apparent diffusion coefficient (ADC) map.

Keyword

Japanese encephalitis; Unilateral involvement; Deep gray matter and temporal lobe; Diffusion-weighted MRI (DWI)

MeSH Terms

Asian Continental Ancestry Group*
Basal Ganglia
Brain
Caudate Nucleus
Cerebellum
Cerebral Cortex
Communicable Diseases
Diffusion
Encephalitis, Japanese*
Far East
Gray Matter*
Humans
Korea
Magnetic Resonance Imaging*
Middle Aged
Pons
Red Nucleus
Substantia Nigra
Temporal Lobe*
Thalamus

Figure

• 

  Fig. 1 A 53-year-old man with JE. Diffusion-weighted imaging (DWI) (b = 1000 s/mm2) (a, b), apparent diffusion coefficient (ADC) map (c, d) and T2-weighted image (DWI b = 0 s/mm2) (e, f) obtained on day 2 after onset of altered mentality show multiple areas of high intensity on DWI (b = 1000 s/mm2) (a, b) and isointensity on ADC map (c, d) in the left thalamus (short arrow), left caudate nucleus (long arrow), left subtantia nigra (arrowhead) and left medial temporal lobe (asterisk). On T2-weighted image (DWI b = 0 s/mm2, e, f), the lesions show subtle high intensity.

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