Acute Necrotizing Encephalopathy of Childhood: Correlation of MR Findings and Clinical Outcome
A.M. Wonga,
E.M. Simonb,
R.A. Zimmermanb,
H.-S. Wangc,
C.-H. Toha and
S.-H. Nga
a Department of Diagnostic Radiology, Chang Gung Memorial Hospital and Chang Gung University, Kwei-Shan, Tao Yuan, Taiwan, Republic of China
b Department of Radiology, The Children’s Hospital of Philadelphia, Philadelphia, Pa
c Division of Pediatric Neurology, Chang Gung Children’s Hospital and Chang Gung University, Kwei-Shan, Tao Yuan, Taiwan, Republic of China
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Fig 1. A 1.3-year-old boy (patient 1) left with spasticity and decerebrate posture. A, coronal T2-weighted imaging (4000 ms/90 ms, repetition time [TR]/echo time [TE]) shows symmetrical hyperintensity in the thalami (arrows), the centrum semiovale (arrowheads), and the brain stem, including the midbrain (double arrowheads) and the pons (double arrows). Note swelling of the thalami.
B, Postcontrast coronal T1-weighted imaging (630 ms/20 ms, TR/TE) shows irregular ringlike enhancement in the thalami (arrows).
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Fig 2. A 2.3-year-old boy (patient 12) with severe sequelae.
A, Axial T1-weighted imaging (449 ms/12 ms, TR/TE) shows sharply marginated hypointensity in the cerebellum (arrowheads).
B, Axial T1-weighted imaging shows hyperintensity in the thalami (arrows) and the right occipital lobe (double arrows). Sharply marginated hypointense areas are found in the cerebral white matter (arrowheads) and the internal capsules (small arrowheads). The lentiform nuclei also show mixed intensity (double arrowheads).
C and D, Coronal T2-weighted imaging show mixed intensity in the thalami (arrows), and hyperintensity in the cerebral white matter, internal capsules (small arrowheads), and the cerebellum (double arrowheads). There are 2 types of white matter lesions: those in the central white matter and internal capsules showing hyperintensity comparable with the CSF (arrowheads) and those in the subcortical regions being less hyperintense (double arrows).
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Fig 3. A 10-year-old boy (patient 5) recovered with hand tremor. Follow-up coronal T2-weighted imaging shows shrunken bilateral thalami with cavitation (arrows).
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