MRI and CT can detect multiorgan failure due to Ebola virus in rhesus macaque model

Authors

• JH Lee
• D Thomasson
• M Castro
• J Solomon
• J Laux
• C Bartos
• K Hagen
• PB Jahrling
• IM Feuerstein
• RF Johnson

Abstract

This report describes MRI and CT imaging findings in three rhesus macaques who survived until day6 (n=2) and day9 (n=1) after Ebola virus (EBOV) inoculation. Three NHP were inoculated with 1000 pfu EBOV intramuscularly. CT and MRI were performed at baseline, and after inoculation on day2, day5, and terminal days. MRI was performed with an FDA-approved hepatocyte-specific contrast agent (gadoxetate). Laboratory assays, physical examinations and necropsy were performed. A staff radiologist reviewed all images. MRI and CT images at baseline and on day2 were normal. On day5, CT showed axillary lymphadenopathy and early lymphedema ipsilateral to the inoculation site, and MRI showed decreased enhancement and mildly decreased biliary function. On terminal days, both showed fulminant hepatic failure and edema, T2 signal loss in the spleen, extensive left axillary adenopathy with chest wall extension, and small bowel dysfunction. Laboratory abnormalities include increases in liver enzyme tests that paralleled the imaging findings; bilirubin also increased but severity lagged the imaging findings. Necropsy confirmed the imaging findings by showing extensive hepatic and splenic necrosis and congestion. These cases are illustrative and typical of the clinical course of Ebola virus infection in this NHP-EBOV model, and faithfully recapitulates the course in humans. MRI and CT in a case of acute EBOV infection demonstrated fulminant multiorgan failure. MRI and CT in a BSL-4 setting can be accomplished and demonstrated diagnostic findings that correlated well with the laboratory, clinical, and necropsy findings. The findings may be diagnostic and may have therapeutic and prognostic implications.

Scientific Focus Area: Virology

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