Marchenko N.V., Voitenkov V.B., Gorelik E.Yu., Bedova M.A., Churkina D.N.,

Dubitsky D.L., Ovchinnikov A.S.


Purpose. Assessment of structural changes and prediction of outcome according to multiparameter magnetic resonance imaging (MRI) of the brain in children with enterovirus encephalitis (EE).

Material and methods. We examined 16 children aged 8.1 ± 4.6 years with EE in the acute period of the disease and early convalescence. The diagnosis was confirmed with laboratory tests (PCR of cerebrospinal fluid and/or blood). Assessment of structural changes was carried out using brain MRI in T1-WI, T2-WI, Flair, T1-WI modes with contrast, as well as with DTI, DWI and MR-spectroscopy.

Results. According to MRI data, isolated lesion of the brain stem was observed in 19% of cases, the brainstem’s damage and the other brain’s parts in 37%, damage to other parts without the brain stem in 13%, and there were no changes in MRI in 31% of cases. Changes in DWI were detected in 27% of cases, the accumulation of contrast agent in 45% of cases, the appearance of lactate in the lesion, an increase in the ratio of Chol/NAA and a decrease in the ratio of NAA/Cr by MR spectroscopy were observed in 27% of cases. A significant ADC increase in the lesion was revealed. A decrease in lesion’s ADC was revealed in dynamics; there was also an increase in DTI fractional anisotropy, a normalization of the Chol/NAA ratio and the NAA/Cr ratio.

Conclusion. Multiparameter MRI can detect changes in the white matter microstructure in the acute period of the disease with an assessment of neuronal density, the presence of anaerobic gliolysis, and differentiate the presence of cytotoxic and vasogenic edema. In the dynamics, there is a decrease in the ADC coefficient in the lesion, indicating regression of edematous changes and restoration of the function of the brain conducting systems. The results of MR-spectroscopy indicate a reliable restoration of cellular metabolism, and, accordingly, a favorable outcome of the disease.


Pediatric Research and Clinical Center for Infectious Diseases. Petersburg, Russia.

Keywords: multiparameter magnetic resonance imaging, enteroviral encephalitis, the brain.


Corresponding author:  Kapishnikov А.V., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript


For citation: Marchenko N.V., Voitenkov V.B., Gorelik E.Yu., Bedova M.A., Churkina D.N., Ovchinnikov A.S. Magnetic resonance imaging in the diagnosis of enteroviral encephalitis in children. REJR 2021; 11(3):35-48. DOI: 10.21569/2222-7415-2021-11-3-35-48.

Received:        08.07.20 Accepted:       25.03.21