Role of Quantitative Diffusion MRI in Categorisation of Early Changes in Children with Viral Encephalitis
Journal Title: International Journal of Anatomy Radiology and Surgery - Year 2018, Vol 7, Issue 1
Abstract
ABSTRACT Introduction: Viral encephalitis is quite common in this part of world. Magnetic Resonance Imaging (MRI) is the first line investigation modality for the accurate detection and diagnosis of encephalitis. Diffusion-Weighted Imaging (DWI) is increasingly used in diagnosis and characterization of cerebral ischemia and infarcts and its role in other conditions like infections is still being discovered. Aim: The aim of this study was to determine the role of quantitative ADC values in the assessment of the early, subacute/delayed and post recovery stages of viral encephalitis in paediatric population. Materials and Methods: Thirty children with encephalitis were studied using both conventional (T2WI and FLAIR) sequences and DWI. These patients were divided into two groups. The Group A patients were those who presented within three days of onset of disease and Group B included those patients who presented after three days of disease onset. The results were compared with the control group for the normal ADC standards. The follow-up of these patients was done three months after the initial onset of symptoms. The ADC values in both the groups were compared to the control group and were statistically analysed. Results: The ADC values in Group A (early) was low with a mean value of 649.0±52.0 while Group B (subacute/ late) showed an increase in ADC with a mean value of 1277.0±138.0. The ADC values of the control group and the Group A patients was found to be statistically significant (p<0.0002) indicating the efficacy of DWI in early detection of encephalitis. Conclusion: MRI and especially FLAIR imaging is the mainstay in the diagnosis of the encephalitic lesions. However, quantitative ADC does help in the early diagnosis of the lesions and in the staging of the lesions. The ADC values were seen to be significantly different in all the 3 groups. Hence, quantitative ADC can be used for staging of the lesions and to predict the resolution of the lesions.
Authors and Affiliations
Shaista Siddiqui, Shagufta Wahab, Rizwan Ahmad Khan
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