Choi Yoon Yeong, Lee Ha Young, Lim Myung Kwan, Kang Young Hye
J Korean Soc Radiol. 2024 May;85(3):682-690. doi: 10.3348/jksr.2023.0023. Epub 2024 May 14.
Acute necrotizing encephalopathy (ANE) is a rare immune-mediated complication of a viral infection commonly involving the bilateral thalamus and has been reported mainly in children. Here, we describe the MRI findings of coronavirus disease 2019 (COVID-19)-associated ANE in two pediatric patients, including a 7-year-old girl with fever and mental change, and a 6-year-old girl with fever and generalized seizures. Brain MRI revealed symmetrical T2 fluid attenuated inversion recovery high-signal intensity lesions in the bilateral thalamus with central hemorrhage. In one patient, the thalamic lesions showed a trilaminar pattern on the apparent diffusion coefficient map. This report emphasizes the importance of creating awareness regarding these findings in patients with COVID-19, particularly in children with severe neurological symptoms. Furthermore, it provides a literature review of several documented cases of COVID-19 presenting with bilateral thalamic hemorrhagic necrosis, suggesting a diagnosis of ANE.
急性坏死性脑病（ANE）是一种罕见的病毒感染免疫介导并发症，通常累及双侧丘脑，主要在儿童中报道。在此，我们描述了两名儿科患者中与2019冠状病毒病（COVID-19）相关的ANE的MRI表现，包括一名7岁发热且有精神改变的女孩和一名6岁发热且有全身性癫痫发作的女孩。脑部MRI显示双侧丘脑对称的T2液体衰减反转恢复高信号强度病变并伴有中央出血。在一名患者中，丘脑病变在表观扩散系数图上呈现三层模式。本报告强调了提高对COVID-19患者这些发现的认识的重要性，特别是对有严重神经症状的儿童。此外，它提供了几例记录在案的表现为双侧丘脑出血性坏死的COVID-19病例的文献综述，提示诊断为ANE。
