Acute Necrotizing Encephalopathy: An Underrecognized Clinicoradiologic Disorder

Figure 3

Diffusion MRI and susceptibility weighted imaging (SWI) findings of acute necrotizing encephalopathy (ANE). (a) was the schematic diagram of typical tricolor pattern corresponding to the thalamic lesions on (b) (a: center of thalamic lesions characterized by hemorrhage and necrosis; b: periphery of the central thalamic lesions characterized by cytotoxic edema; c: outside portions of the thalamic lesions suggesting vasogenic edema). (b) and (c), (d) and (e) were the apparent diffusion coefficient (ADC) and diffusion-weighted image (DWI), respectively, at onset which suggested the bilateral thalamus and brain stem lesions (blue arrow). (f) and (g), (h) and (i) were the ADC and DWI imaging of follow-up which revealed disappearance of the brain stem lesions and hemosiderin deposition on bilateral thalamus (red arrow). (j), (k), and (l) were the follow-up SWI images which showed hemosiderin deposition in the bilateral thalami and the cerebella (red arrow).