DIFFUSION TENSOR MRI IN THE DIAGNOSTIC OF ACUTE VIRAL ENCEPHALITIS IN CHILDREN
Abstract
Introduction. Viral encephalitis is the most common cause of infectional and inflammatory brain damage in children, which has important clinical significance due to its high mortality rate and residual neurological consequences. The diffusion tensor magnetic resonance imaging (DT MRI) uses for assessing the integrity of the nerve tracts and their involvement in the inflammatory process and includes the assessment of parameters such as fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD). Purpose of the study. To identify changes in diffusion tensor imaging (DTI) in the acute viral encephalitis caused by different viral agents in children. Materials and methods. The study includes 30 patients of different ages with a verified diagnosis in the acute phase of the viral encephalitis. Results. It was noticed that all patients that have in foci the inflammatory changes in the white matter, without signs of cytotoxic edema during the acute period of the disease also have a significant decrease in FA, an increase in RD and AD in comparison with the intact symmetrical area of the brain in the contralateral cerebral hemisphere. Conclusion. The acute period of viral encephalitis is characterized by structural changes in the nerve tracts, which are associated with swelling and disorganization of nerve fibers. Changes of DTI in viral encephalitis are comparable to other pathologies that affect white matter of the brain and reflect the pathophysiological processes that serve as the basis for inflammation. Using of the DTI for an in-depth study of changes in the brain during an infectious brain lesion allows to study anatomical information about the functional state of the brain in a non-invasive way, which in the future can become the basis for developing personalized therapy depending on the nature of the damage to the brain tissue.
References
Sonneville R., Jaquet P., Vellieux G., de Montmollin E., Visseaux B. Intensive care management of patients with viral encephalitis. Rev Neurol (Paris). 2022;178(1-2):48–56.
Venkatesan A., Tunkel A.R., Bloch K.C., Lauring A.S., Sejvar J., Bitnun A. et al. Case definitions, diagnostic algorithms, and priorities in encephalitis: consensus statement of the international encephalitis consortium. Clin Infect Dis. 2013; 57:1114–1128.
Марченко Н.В., Войтенков В.Б., Горелик Е.Ю. и др. Мультипараметрическая магнитно-резонансная томография в диагностике энцефалита, вызванного герпесвирусами, у детей. Лучевая диагностика и терапия. 2021;4(12):23–32.
Войтенков В.Б., Синкин М.В., Скрипченко Н.В., Екушева Е.В., Горелик Е.Ю., Марченко Н.В., Штеклейн А.В., Бедова М.А. Биоэлектрическая активность головного мозга у детей с острым вирусным энцефалитом. Российский физиологический журнал им. И.М. Сеченова. 2020;196(7):1–8.
Kneen R., Michael B.D., Menson E., Mehta B., Easton A., Hemingway C. et al. Management of suspected viral encephalitis in children — Association of British Neurologists and British Paediatric Allergy, Immunology and Infection Group National Guidelines. J Infect. 2012;64:449–477.
Марченко Н.В., Войтенков В.Б., Скрипченко Н.В., Бедова М.А., Курзанцева О.О. Магнитно-резонансная томография как инструмент дифференциальной диагностики при поражении ствола головного мозга у детей. Клиническая практика. 2020;11(1):81–91.
Wang Y., Xu M., Geng L., Zhao Y., Guo Z., Fan Y, Niu Y. DTI Atlases Evaluations. Neuroinformatics. 2022;20(2):327–351.
Mori S., Tournier J.D. Introduction to diffusion tensor imaging: And higher order models: Second edition. Elsevier Inc.; 2013.
Марченко Н.В., Новокшонов Д.Ю., Шевченко Е.Ю., Бедова М.А., Алиев Р.В., Дубицкий Д.Л., Климкин А.В., Войтенков В.Б., Скрипченко Н.В. Показатели фракционной анизотропии вещества головного мозга у здоровых детей: когортное исследование. Лучевая диагностика и терапия. 2022;3(13):7–17.
Beaulieu C. The Biological Basis of Diffusion Anisotropy. Diffusion MRI. Academic Press; 2009.
Алиев Р.В., Ирикова М.А., Васильева Ю.П., Вильниц А.А., Войтенков В.Б., Горелик Е.Ю., Дубицкий Д.Л., Климкин А.В., Марченко Н.В., Новокшонов Д.Ю., Скрипченко Н.В., Скрипченко Е.Ю., Шевченко Е.Ю. Нейровизуализация при энцефалитах и менингитах у детей. Санкт-Петербург; 2023.
Jellison B.J., Field A.S., Medow J., Lazar М., Shariar M.S., Andrew L.A. Diffusion tensor imaging of cerebral white matter: a pictorial review of physics, fiber tract anatomy, and tumor imaging patterns. Am J Neuroradiol. 2004;25(3):356–369.
Китаев С.В., Попова Т.А. Принципы визуализации диффузионного тензора и его применение в неврологии. Анналы клинической и экспериментальной неврологии. 2012;(1):48–54.
Larvie M., Fischl B. Volumetric and fiber-tracing MRI methods for gray and white matter. Handb Clin Neurol. 2016;135:39–58.
Qiu D., Tan L. H., Zhou K., Khong P.L. Diffusion tensor imaging of normal white matter maturation from late childhood to young adulthood: voxel-wise evaluation of mean diffusivity, fractional anisotropy, radial and axial diffusivities, and correlation with reading development. NeuroImage. 2008;41(2):223–232.
Брюхов В.В., Куликова С.Н., Кротенкова М.В., Переседова А.В., Завалишин И.А. Современные методы визуализации в патогенезе рассеянного склероза. Анналы клинической и экспериментальной неврологии. 2013;3:47–53.
Della Nave R., Ginestroni A., Diciotti S., Salvatore E., Soricelli A., Mascalchi M. Axial diffusivity is increased in the degenerating superior cerebellar peduncles of Friedreich's ataxia. Neuroradiology. 2010;53(5):367–372.
Ceccarelli A., Rocca M. A., Falini A., Tortorella P., Pagani E., Rodegher M., Comi G., Scotti G., Filippi M. Normal-appearing white and grey matter damage in MS: a volumetric and diffusion tensor MRI study at 3.0 Tesla. J Neurol. 2007;254(4):513–518.
Марченко Н.В., Войтенков В.Б., Скрипченко Н.В., Курзанцева О.О. Магнитно-резонансная томография как инструмент прогнозирования при энцефалитах у детей. Клиническая практика. 2019;10(3):55–60.
Cauley K.A., Burbank H.N., Filippi C.G. Diffusion tensor imaging and tractography of Rasmussen encephalitis. Pediatr Radiol. 2009;39(7):727–730.
Saurabh K., Singh V.K., Pathak A., Chaurasia R.N., Verma A., Mishra V.N., Joshi D., Kumar A. Clinical profile and diffusion tensor imaging in patients of subacute sclerosing pan encephalitis: a prospective follow-up study from eastern part of india. Neurol India. 2022;70(1):197–202.
Liang Y., Cai L., Zhou X., Huang H., Zheng J. Voxel-based analysis and multivariate pattern analysis of diffusion tensor imaging study in anti-NMDA receptor encephalitis. Neuroradiology. 2020;62(2):231–239.
Rocca M.A., Preziosa P., Mesaros S. et al. Clinically isolated syndrome suggestive of multiple sclerosis: dynamic patterns of gray and white matter changes-a 2-year MR imaging study. Radiology. 2016;278(3):841–853.
Ontaneda D., Sakaie K., Lin J. et al. Measuring brain tissue integrity during 4 years using diffusion tensor imaging. AJNR Am J Neuroradiol. 2017;38(1):31–38.
Klistorner A., Wang C., Fofanova V. et al. Diffusivity in multiple sclerosis lesions: at the cutting edge? Neuroimage Clin. 2016;12:219–226.
Kraus M.F., Susmaras T., Caughlin B.P., Walker C.J., Sweeney J.A., Little D.M. White matter integrity and cognition in chronic traumatic brain injury: a diffusion tensor imaging study. Brain. 2007;130(10):2508–2519.
