Infection and Encephalitis
Magnetic resonance spectroscopy (MRS) serves as a powerful tool in narrowing the differential diagnosis in pediatric brain disorders. Unfortunately, the literature provides only a limited number of case reports and larger patient series employing this technique in the diagnosis and monitoring of infectious and inflammatory conditions. For these conditions producing encephalitis, MRS often demonstrates a more benign spectral appearance, with minor changes in metabolite levels, which contrasts to the typically more dramatic and often aggressive spectral features recognized in neoplasms and metabolic disorders. One key exception is frank abscess, as this process depletes the metabolites found in normal brain parenchyma and replaces them with distinct amino acids. This chapter first describes some practical and technical concerns associated with conducting neurological MRS studies in the pediatric patients to confirm the diagnosis of an infectious and/or inflammatory process. A brief description of infectious disorders and inflammatory conditions with illustrative imaging and spectroscopy examples from our center and the literature will provide important information in diagnosing these conditions.
KeywordsHuman Immunodeficiency Virus Epstein Barr Virus Magnetic Resonance Spectroscopy Acquire Immune Deficiency Syndrome Brain Abscess
This work was supported by grants from the National Institutes of Health, NIEHS R01 ES015559, NCI R01 CA112182, and NIMH P50 MH077138. The authors have no competing financial or non-financial interests to declare.
- 14.van der Voorn JP, Pouwels PJ, Vermeulen RJ, Barkhof F, van der Knaap MS. Quantitative MR imaging and spectroscopy in congenital cytomegalovirus infection and periventricular leukomalacia suggests a comparable neuropathological substrate of the cerebral white matter lesions. Neuropediatrics. 2009;40(4):168–73.PubMedCrossRefGoogle Scholar