Figure 1.
Brain magnetic resonance imaging in children with influenza A(H1N1)pdm09 acute necrotizing encephalopathy admitted to Meyer Children’s Hospital, Florence, Italy, December 2023–January 2024 (n = 3)
ADC: apparent diffusion coefficient; FLAIR: fluid attenuated inversion recovery; MRI: magnetic resonance imaging; PICU: paediatric intensive care unit.
A–D: MRI brain images from patient PICU 1. Diffusion weighted imaging (DWI) sequence (A) and ADC map (B) highlighting restricted diffusion in the putamen bilaterally. T2-FLAIR image showing oedema and hyperintense signal involving the thalami, putamen and caudate nuclei (C) and brainstem (D).
E–F: MRI brain images from patient PICU 2: T2-weighted images on the initial MRI (E) and 60 h later (F) showing progression from normal myelination pattern to diffuse white matter injury.
G–J: MRI brain images from patient PICU 3: T2-FLAIR images showing diffusely hyperintense signal in the midbrain and bilateral temporal lobes on the initial MRI (G) and 6 days later (H), and in the thalami on the initial MRI (I) and 6 days later (J).
