Objective To analyze and summarize the MRI findings of children with different types of encephalopathy af-ter novel coronavirus infection,so as to providing image information for clinical timely and reasonable treatment.Methods Clinical and MRI imaging data of 16 clinically diagnosed children with novel coronavirus infection complicated with central nervous system involvement admitted were retrospectively analyzed,including 9 males and 7 females,aged 13 days to 12 years.All the patients underwent MRI plain scan and diffusion weighted imaging(DWI).Among them,11 cases were re-examined at different times.Results Combined with clinical findings and laboratory examination,8 cases were consid-ered as acute necrotic encephalopathy,of which 7 cases involved a wide range of brain substance.MRI showed obvious bi-lateral thalamic swelling with symmetrical changes,low signal on T1WI,high signal on T2WI and FLAIR,high signal on DWI,and"trichromatic plate sign"on ADC.Multiple symmetrical patchy DWI high signals were seen in the remaining bi-lateral cerebral hemispheres,and only the brain stem was involved in 1 case.MRI showed obvious swelling of the brain stem,abnormal patchy signals in the brain stem,low signals on T1WI,high signals on T2WI and FLAIR,high signals on DWI,and"tricolor sign"on ADC.Reye's syndrome was considered in 2 cases.MRI showed diffuse symmetry of low T1 WI signal,high T2WI signal,high FLAIR and DWI signal,and decreased ADC in both cerebral cortex and basal ganglia.Four patients were considered to have acute encephalopathy with biphasic seizures and late reduced diffusion(AESD).MRI showed slightly longer symmetrical T,and T2 signals in the white matter of the frontal parietal occipital lobe,high FLAIR signal,high DWI signal,and reduced ADC,showing"bright tree sign".In the two cases,MRI showed flaky T1 WI low T2WI high signal scattered at multiple points in the intracranial white matter divide of both cerebral hemispheres,FLAIR and DWI showed high signal,ADC decreased,and fronto-parietal flaky T1WI high signal,which was considered to be a-cute encephalopathy complicated with vascular disease.Conclusion Novel coronavirus infection in children can be com-plicated with acute necrotic encephalopathy,Reye's syndrome,AESD and acute encephalopathy complicated with cerebro-vascular lesions.MRI findings of different types of encephalopathy are different.To summarize the imaging characteristics,improve the diagnostic ability,and provide important imaging information for clinical reasonable and timely treatment.
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