Brain perfusion alterations in tick-borne encephalitis-preliminary report

Background: Magnetic resonance imaging (MRI) changes in tick-borne encephalitis (TBE) are non-specific and the pathophysiological mechanisms leading to their formation remain unclear. This study investigated brain perfusion in TBE patients using dynamic susceptibility- weighted contrast-enhanced magnetic resonance perfusion imaging (DSC-MRI perfusion). Methods: MRI scans were performed for 12 patients in the acute phase, 3-5 days after the diagnosis of TBE. Conventional MRI and DSC-MRI perfusion studies were performed. Cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and time to peak (TTP) parametric maps were created. The bilateral frontal, parietal, and temporal subcortical regions and thalamus were selected as regions of interest. Perfusion parameters of TBE patients were compared to those of a control group. Results: There was a slight increase in CBF and CBV, with significant prolongation of TTP in subcortical areas in the study subjects, while MTT values were comparable to those of the control group. A significant increase in thalamic CBF (p < 0.001) and increased CBV (p < 0.05) were observed. Increased TTP and a slight reduction in MTT were also observed within this area. Conclusions: The DSC-MRI perfusion study showed that TBE patients had brain perfusion disturbances, expressed mainly in the thalami. These results suggest that DSC-MRI perfusion may provide important information regarding the areas affected in TBE patients. (C) 2018 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.