Abstract：
Human bornavirus encephalitis is an emerging disease caused by the variegated squirrel bornavirus 1 (VSBV-1) and the Borna disease virus 1 (BoDV-1). While characteristic brain magnetic resonance imaging (MRI) changes have been described for BoDV-1 encephalitis, only scarce diagnostic data in VSBV-1 encephalitis exist. We systematically analysed brain MRI scans from all known VSBV-1 encephalitis patients. Initial and follow-up scans demonstrated characteristic T2 hyperintense lesions in the limbic system and the basal ganglia, followed by the brainstem. No involvement of the cerebellar cortex was seen. Deep white matter affection occurred in a later stage of the disease. Strict symmetry of pathologic changes was seen in 62%. T2 hyperintense areas were often associated with low T1 signal intensity and with mass effect. Sinusitis in three patients on the first MRI and an early involvement of the limbic system suggest an olfactory route of VSBV-1 entry. The viral spread could occur per continuitatem to adjacent anatomical brain regions or along specific neural tracts to more distant brain regions. The number and extent of lesions did not correlate with the length of patients\' survivals. The overall pattern closely resembles that described for BoDV-1 encephalitis. The exact bornavirus species can thus not be deduced from imaging results alone, and molecular testing and serology should be performed to confirm the causative bornavirus. As VSBV-1 is likely of tropical origin, and MRI investigations are increasingly available globally, imaging techniques might be helpful to facilitate an early presumptive diagnosis of VSBV-1 encephalitis when molecular and/or serological testing is not available.
摘要：
摘要：人博尔纳病毒脑炎是由杂色松鼠博尔纳病毒1（VSBV-1）和博尔纳病病毒1（BoDV-1）引起的一种新出现的疾病。虽然已经描述了BoDV-1脑炎的特征性脑磁共振成像（MRI）变化，VSBV-1脑炎的诊断数据很少.我们系统分析了所有已知的VSBV-1脑炎患者的脑MRI扫描。初始和随访扫描显示边缘系统和基底神经节的特征性T2高强度病变，其次是脑干。未发现小脑皮层受累。深部白质病变发生在疾病的晚期。62％的病理变化具有严格的对称性。T2高强度区域通常与低T1信号强度和质量效应有关。在首次MRI检查中，三名患者的鼻窦炎和边缘系统的早期受累提示VSBV-1进入的嗅觉途径。病毒的传播可能会持续到相邻的解剖大脑区域，或者沿着特定的神经束传播到更远的大脑区域。病变的数量和程度与患者的生存期无关。总体模式与BoDV-1脑炎的描述非常相似。因此，无法仅从成像结果中推断出确切的博纳病毒种类，应进行分子检测和血清学检查以确认致病性博尔纳病毒。由于VSBV-1可能是热带起源，MRI检查在全球范围内越来越多，当无法进行分子和/或血清学检测时,成像技术可能有助于VSBV-1脑炎的早期推定诊断.
