PDF(Pubmed)
Abstract：
Rabies is an acute fatal disease of the central nervous system. Neuroimaging plays an important role, especially in establishing an early diagnosis and distinguishing it from other types of encephalitis. This case report aims to give a brief review of this condition and report the less common MRI findings of the disease. We herein report a case of a 61-year-old male bitten by a stray dog who presented with fever, vomiting, headache, sialorrhea, dysarthria, dysphagia, and upper limb weakness which progressed to lower limbs on the next day. T2W and FLAIR images demonstrated subtle bilateral hyperintense signal in the deep gray matter with more apparent increased signal intensity in the white matter of the frontal and parietal lobes which shows mild diffusion restriction but no postcontrast enhancement. The diagnosis of rabies encephalitis was made based on a typical history of exposure, a compatible clinical presentation, and MRI findings. Rabies diagnosis is essentially clinical. It is definitively confirmed by the isolation of the virus from biological samples such as saliva, CSF, hair, or detection of rabies antigens or antibodies. Magnetic resonance imaging (MRI) brain used as one of the modalities of investigation for distinguishing it from other encephalitis. Rabies per se does not have any characteristic features on the MRI brain.
摘要：
狂犬病是中枢神经体系的一种急性致命疾病。神经影像学发挥着重要作用,特别是在建立早期诊断和区分它与其他类型的脑炎。此病例报告旨在对这种情况进行简要回顾，并报告该疾病不太常见的MRI发现。我们在此报告一例61岁的男性被流浪狗咬伤，并出现发烧，呕吐,头痛,流涎,构音障碍,吞咽困难,上肢无力在第二天发展到下肢。T2W和FLAIR图像显示深灰质中微妙的双侧高强度信号，额叶和顶叶白质中的信号强度更明显地增加，显示出轻度的弥散限制，但没有对比后增强。狂犬病脑炎的诊断是根据典型的暴露史做出的，兼容的临床表现，和MRI检查结果。狂犬病的诊断基本上是临床的。从唾液等生物样品中分离出病毒，CSF,头发,或检测狂犬病抗原或抗体。磁共振成像（MRI）大脑用作将其与其他脑炎区分开的研究方式之一。狂犬病本身在MRI大脑上没有任何特征性特征。
