Department of Pediatrics, Graduate School of Medicine, Gifu University, 1-1 Yanagido, 501-1194 Gifu, Japan.
World J Pediatr. 2013 Feb;9(1):87-9. doi: 10.1007/s12519-011-0298-0. Epub 2011 Aug 27.
Rotavirus infection is occasionally associated with central nervous system involvement, including cerebellitis. However, the precise clinical sequelae of central nervous system disorders and the usefulness of neuroradiological examination for clinical therapies, such as steroid pulse therapy, have not been clarified.
We present a case of rotavirus cerebellitis examined by magnetic resonance imaging (MRI), magnetic resonance spectroscopy, and single photon emission computed tomography.
MRI demonstrated abnormal intensities in the right cerebellum on fluid attenuated inversion recovery images and, much more obviously, on diffusion-weighted images, but not on T1- or T2-weighted images. Single photon emission computed tomography showed only mild hypoperfusion in the right cerebellum on the 15th day, while 4 weeks later the image showed remarkably low perfusion in the right cerebellum.
The findings of the reported case suggest the importance of performing radiological examinations at early phases of the disease, especially by new modalities such as diffusion weighted imaging, to make timely and appropriate therapeutic decisions.
轮状病毒感染偶尔会涉及中枢神经系统,包括小脑炎。然而,中枢神经系统疾病的确切临床后果以及神经影像学检查对临床治疗(如类固醇冲击疗法)的作用尚不清楚。
我们报告了一例轮状病毒小脑炎的病例,该病例接受了磁共振成像(MRI)、磁共振波谱和单光子发射计算机断层扫描检查。
MRI 显示在液体衰减反转恢复图像上以及在弥散加权图像上(而非在 T1 或 T2 加权图像上)右小脑存在异常信号强度。单光子发射计算机断层扫描显示在第 15 天仅在右小脑有轻度低灌注,而 4 周后图像显示右小脑明显低灌注。
本病例的结果提示在疾病早期进行影像学检查的重要性,特别是通过新的方式如弥散加权成像,以便及时做出适当的治疗决策。