Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
J Neuroimaging. 2021 May;31(3):609-614. doi: 10.1111/jon.12833. Epub 2021 Feb 3.
Rabies encephalitis is a near-fatal zoonotic disease that is usually diagnosed on clinical grounds in conjunction with characteristic history. Owing to its rapidly progressive nature, imaging is seldom performed, and hence a description of imaging findings in rabies encephalitis is anecdotal and limited.
We describe MRI findings in eight confirmed rabies cases that presented to our institute over the last 21 years.
Most of the patients' imaging patterns are in concordance with the described literature. However, we hereby demonstrate the involvement of novel structures like dentate nuclei, cranial nerves, and meninges besides the hot cross bun sign in the pons and the presence of diffusion restriction in many gray and white matter structures of the brain.
Knowledge of the broad imaging spectrum of rabies may expedite the diagnosis, especially the paralytic form, which is prone to clinical misdiagnosis as Guillain-Barre syndrome or acute disseminated encephalomyelitis.
狂犬病脑炎是一种接近致命的人畜共患病，通常根据临床特征并结合特征性病史进行诊断。由于其迅速进展的性质，很少进行影像学检查，因此对狂犬病脑炎的影像学表现的描述是轶事性的，并且有限。
我们描述了过去 21 年来在我们研究所就诊的 8 例确诊狂犬病病例的 MRI 发现。
大多数患者的影像学模式与文献描述一致。然而，我们在此证明了除了桥脑的十字面包征和大脑许多灰质和白质结构的弥散受限外，新型结构如齿状核、颅神经和脑膜也参与其中。
对狂犬病广泛的影像学谱的认识可以加快诊断，特别是麻痹型，易误诊为格林-巴利综合征或急性播散性脑脊髓炎。
