BACKGROUND: Cerebral malaria is a major health hazard, with a high incidence of mortality. The disease is endemic in many developing countries, but with a greater increase in tourism, occasional cases may be detected in countries where the disease in not prevalent. Early diagnosis and evaluation of cerebral involvement in malaria utilizing modern imaging modalities have an impact on the treatment and clinical outcome. PURPOSE: To evaluate the magnetic resonance (MR) features of patients with cerebral malaria presenting with altered sensorium. MATERIAL AND METHODS: We present the findings in three patients with cerebral malaria presenting with altered sensorium. MR imaging using a 1.5-Tesla unit was carried out. The sequences performed were 5-mm-thick T1-weighted, T2-weighted, fluid-attenuated inversion-recovery (FLAIR), and T2-weighted gradient-echo axial sequences, and sagittal and coronal FLAIR. Diffusion-weighted imaging was performed with b values of 0 and 1000 s/mm(2), and apparent diffusion coefficient (ADC) maps were obtained. RESULTS: Focal hyperintensities in the bilateral periventricular white matter, corpus callosum, occipital subcortex, and bilateral thalami were noticed on T2-weighted and FLAIR sequences. The lesions were more marked in the splenium of the corpus callosum. No enhancement on postcontrast T1-weighted MR images was observed. There was no evidence of restricted diffusion on the diffusion-weighted sequence and ADC map. CONCLUSION: MR is a sensitive imaging modality, with a role in the assessment of cerebral lesions in malaria. Focal white matter and corpus callosal lesions without any restricted diffusion were the key findings in our patients.
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机译：背景：脑疟疾是一种主要的健康隐患，死亡率很高。该疾病在许多发展中国家是地方病，但是随着旅游业的增加，在这种疾病不普遍的国家可能会发现一些偶然病例。利用现代成像方式对疟疾中脑部疾病的早期诊断和评估对治疗和临床结果具有影响。目的：评估感官改变的脑疟疾患者的磁共振（MR）特征。材料与方法：我们介绍了三例脑部感冒改变的脑疟疾患者的发现。使用1.5 Tesla单元进行MR成像。所执行的序列为5毫米厚的T1加权，T2加权，流体衰减倒置恢复（FLAIR）和T2加权梯度回波轴向序列，以及矢状和冠状FLAIR。使用b值0和1000 s / mm（2）进行扩散加权成像，并获得表观扩散系数（ADC）图。结果：在T2加权和FLAIR序列上发现了双侧脑室周围白质，call体，枕下皮层和双侧丘脑的局灶性高信号。病变在call体脾中更明显。对比后T1加权MR图像未见增强。在扩散加权序列和ADC图上没有限制扩散的迹象。结论：MR是一种敏感的影像学检查手段，在评估疟疾脑损伤方面具有重要作用。无局限性扩散的局灶性白质和体病变是我们患者的主要发现。
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