Wertigkeit der MRT in der Diagnostik primärer und sekundärer zerebraler Infektionen

Zusammenfassung

Zerebrale Infektionen können letal verlaufen, Voraussetzung für eine schnelle und effektive Therapie ist eine frühzeitige Diagnose. Eine allgemein anerkannte Methode ist die Bildgebung mittels MRT, in der vorliegenden Arbeit soll eine Übersicht über wichtige Sequenzen und charakteristische Bildmuster, jedoch auch über Grenzen ihrer Aussagekraft gegeben werden.

Abstract

Cerebral infections may develop into a life-threatening condition. Fast and correct diagnosis is crucial for a differentiated therapy and MRI imaging is widely accepted as the method of choice. Both specific MR sequences and imaging characteristics of major cerebral infections are addressed in this overview. Furthermore, limitations and pitfalls of the method are discussed.

Key words

brain - infection - MRI

• Literatur

• 1 McClelland 3rd S, Hall WA. Postoperative central nervous system infection: Incidence and associated factors in 2111 neurosurgical procedures. Clin Infect Dis 2007; 45: 55-59
• 2 Dashti SR, Baharvahdat H, Spetzler RF et al. Operative intracranial infection following craniotomy. Neurosurg Focus 2008; 24: E10
• 3 Luthra G, Parihar A, Nath K et al. Comparative evaluation of fungal, tubercular, and pyogenic brain abscesses with conventional and diffusion MR imaging and proton MR spectroscopy. Am J Neuroradiol 2007; 28: 1332-1338
• 4 Horger M, Nagele T, Joanoviciu SD et al. Bildgebung von Zerebritis und Hirnabszess. Fortschr Röntgenstr 2009; 181: 831-835
• 5 Cartes-Zumelzu FW, Stavrou I, Castillo M et al. Diffusion-weighted imaging in the assessment of brain abscesses therapy. Am J Neuroradiol 2004; 25: 1310-1317
• 6 Guzman R, Barth A, Lovblad KO et al. Use of diffusion-weighted magnetic resonance imaging in differentiating purulent brain processes from cystic brain tumors. J Neurosurg 2002; 97: 1101-1107
• 7 Mishra AM, Gupta RK, Saksena S et al. Biological correlates of diffusivity in brain abscess. Magnetic Resonance in Medicine 2005; 54: 878-885
• 8 Farrell CJ, Hoh BL, Pisculli ML et al. Limitations of diffusion-weighted imaging in the diagnosis of postoperative infections. Neurosurgery 2008; 62: 577-583 ; discussion 577-583
• 9 Wang S, Kim S, Chawla S et al. Differentiation between glioblastomas, solitary brain metastases, and primary cerebral lymphomas using diffusion tensor and dynamic susceptibility contrast-enhanced MR imaging. Am J Neuroradiol 2011; 32: 507-514
• 10 Karampekios S, Hesselink J. Cerebral infections. Eur Radiol 2005; 15: 485-493
• 11 Gasparotti R, Pinelli L, Liserre R. New MR sequences in daily practice: Susceptibility weighted imaging. A pictorial essay. Insights Imaging 2011; 2: 335-347
• 12 Kim HS, Jahng GH, Ryu CW et al. Added value and diagnostic performance of intratumoral susceptibility signals in the differential diagnosis of solitary enhancing brain lesions: Preliminary study. Am J Neuroradiol 2009; 30: 1574-1579
• 13 Heye T, Stoijkovic M, Kauczor HU et al. Extrapulmonale Tuberkulose: Die radiologische Bildgebung eines fast vergessenen Verwandlungskünstlers. Fortschr Röntgenstr 2011; 183: 1019-1029
• 14 Hartmann KM, Golinski M, Reith W. ZNS-Infektionen bei immunsupprimierten Patienten. Radiologe 2008; 48: 560-571
• 15 Hähnel S, Storch-Hagenlocher B, Kress B et al. Infektiöse Erkrankungen des Hirnparenchyms bei Erwachsenen: Bildgebung und differenzialdiagnostische Aspekte. Fortschr Röntgenstr 2005; 177: 1349-1365
• 16 Leitlinien für Diagnostik und Therapie in der Neurologie. 4. überarbeitete Aufl. Stuttgart: Georg Thieme Verlag; 2008
• 17 Ho EL, Lukehart SA. Syphilis: Using modern approaches to understand an old disease. J Clin Invest 2011; 121: 4584-4592
• 18 Peng F, Hu X, Zhong X et al. CT and MR findings in hiv-negative neurosyphilis. Eur J Radiol 2008; 66: 1-6
• 19 Krope K, Pantazis G, Nagele T et al. Sporadische Creutzfeld- Jacob-Krankheit. Fortschr Röntgenstr 2011; 183: 593-596
• 20 Haïk S, Brandel JP, Sazdovitch V et al. Dementia with lewy bodies in a neuropathologic series of suspected Creutzfeldt-Jakob disease. Neurology 2000; 55: 1401-1404
• 21 Poser S, Mollenhauer B, Kraubeta A et al. How to improve the clinical diagnosis of Creutzfeldt-Jakob disease. Brain 1999; 122: 2345-2351
• 22 Arruda WO, Bordignon KC, Milano JB et al. Doença de Creutzfeldt-Jakob forma heidenhain: Relato de caso com achados de ressonância magnética e dwi. Arq Neuropsiquiatr 2004; 62: 347-352
• 23 Meissner B, Kallenberg K, Sanchez-Juan P et al. MRI lesion profiles in sporadic Creutzfeldt-Jakob disease. Neurology 2009; 72: 1994-2001
• 24 Meissner B, Kallenberg K, Sanchez-Juan P et al. Isolated cortical signal increase on MR imaging as a frequent lesion pattern in sporadic Creutzfeldt-Jakob disease. Am J Neuroradiol 2008; 29: 1519-1524
• 25 Kallenberg K, Schulz-Schaeffer WJ, Jastrow U et al. Creutzfeldt-Jakob disease: Comparative analysis of MR imaging sequences. Am J Neuroradiol 2006; 27: 1459-1462
• 26 Galanaud D, Haik S, Linguraru MG et al. Combined diffusion imaging and MR spectroscopy in the diagnosis of human prion diseases. Am J Neuroradiol 2010; 31: 1311-1318
• 27 Frantzidou F, Kamaria F, Dumaidi K et al. Aseptic meningitis and encephalitis because of herpesviruses and enteroviruses in an immunocompetent adult population. Eur J Neurol 2008; 15: 995-997
• 28 Johnson R. Viral infections of the nervous system. 2 ed. Philadelphia, New York: Lippincott-Raven; 1998
• 29 Whitley R. Herpes simplex virus. Philadelphia, New York: Lippincott-Raven; 1997
• 30 Leonard JR, Moran CJ, Cross 3rd DT et al. MR imaging of herpes simplex type 1 encephalitis in infants and young children: A separate pattern of findings. Am J Roentgenol 2000; 174: 1651-1655
• 31 Lakeman FD, Whitley RJ. Diagnosis of herpes simplex encephalitis: Application of polymerase chain reaction to cerebrospinal fluid from brain-biopsied patients and correlation with disease. National institute of allergy and infectious diseases collaborative antiviral study group. J Infect Dis 1995; 171: 857-863
• 32 Johnson B. Intracranial infections. Philadelphia: Saunders; 2000
• 33 Vossough A, Zimmerman R, Bilaniuk L et al. Imaging findings of neonatal herpes simplex virus type 2 encephalitis. Neuroradiology 2008; 50 (4) 355-366
• 34 Mori I, Nishiyama Y, Yokochi T et al. Olfactory transmission of neurotropic viruses. J Neurovirol 2005; 11: 129-137
• 35 Bash S, Hathout GM, Cohen S. Mesiotemporal t2-weighted hyperintensity: Neurosyphilis mimicking herpes encephalitis. American Journal of Neuroradiology 2001; 22: 314-316
• 36 Cunha BA, Fatehpuria R, Eisenstein LE. Listeria monocytogenes encephalitis mimicking herpes simplex virus encephalitis: The differential diagnostic importance of cerebrospinal fluid lactic acid levels. Heart Lung 2007; 36: 226-231
• 37 Chang KH, Han MH. MRI of CNS parasitic diseases. Journal of Magnetic Resonance Imaging 1998; 8: 297-307
• 38 Bohlsen D, Vollmann R, Simbrunner J. Atypische zerebrale Toxoplasmose nach Nierentransplantation. Fortschr Röntgenstr 2011; 183: 762-764
• 39 Chang L, Ernst T. MR spectroscopy and diffusion-weighted MR imaging in focal brain lesions in aids. Neuroimaging Clin N Am 1997; 7: 409-426
• 40 Ernst TM, Chang L, Witt MD et al. Cerebral toxoplasmosis and lymphoma in aids: Perfusion MR imaging experience in 13 patients. Radiology 1998; 208: 663-669
• 41 Rapidis AD. Orbitomaxillary mucormycosis (zygomycosis) and the surgical approach to treatment: Perspectives from a maxillofacial surgeon. Clin Microbiol Infect 2009; 15: 98-102
• 42 Horger M, Beschorner R, Beck R et al. Common and uncommon imaging findings in progressive multifocal leukoencephalopathy (pml) with differential diagnostic considerations. Clin Neurol Neurosurg 2012; Oct; 114 (8) 1123-1130
• 43 Weber T, Trebst C, Frye S et al. Analysis of the systemic and intrathecal humoral immune response in progressive multifocal leukoencephalopathy. J Infect Dis 1997; 176: 250-254
• 44 Mader I, Herrlinger U, Klose U et al. Progressive multifocal leukoencephalopathy: Analysis of lesion development with diffusion-weighted MRI. Neuroradiology 2003; 45: 717-721
• 45 Atlas SW. Magnetic resonance imaging of the brain. 4th ed. Philadelphia, Lippincott: Williams&Wilkins; 2009
• 46 Tan CS, Koralnik IJ. Progressive multifocal leukoencephalopathy and other disorders caused by jc virus: Clinical features and pathogenesis. Lancet Neurol 2010; 9: 425-437
• 47 Behzad-Behbahani A, Klapper PE, Vallely PJ et al. Bkv-DNA and jcv-DNA in csf of patients with suspected meningitis or encephalitis. Infection 2003; 31: 374-378
• 48 Wüthrich C, Dang X, Westmoreland S et al. Fulminant jc virus encephalopathy with productive infection of cortical pyramidal neurons. Ann Neurol 2009; 65: 742-748
• 49 Sahraian MA, Radue EW, Eshaghi A et al. Progressive multifocal leukoencephalopathy: A review of the neuroimaging features and differential diagnosis. Eur J Neurol 2012; 19: 1060-1069
• 50 Clifford DB, De Luca A, Simpson DM et al. Natalizumab-associated progressive multifocal leukoencephalopathy in patients with multiple sclerosis: Lessons from 28 cases. Lancet Neurol 2010; 9: 438-446