Abstract: Objective　To analyze and summarize the MRI imaging features of toxic encephalopathy caused by Vietnamese sophora root in children, and to improve the understanding on the disease. Methods　Combined with relevant literatures, the clinical data of 4 children with toxic encephalopathy caused by Vietnamese sophora root in Children's Hospital of Zhengzhou University from December 2015 to April 2020 were retrospectively analyzed, including 2 males and 2 females (twin sisters), aged 5-9 years. All cases underwent MRI plain scan and additional scan of diffusion weighted imaging (DWI) sequence, 3 cases were reviewed, and 1 case was not reviewed. Results　The brainstem and dentate nuclei of bilateral cerebellar hemispheres were involved in all 4 cases, showing symmetrical changes, with iso-slightly hypointense signal on T1WI, hyperintensity on T2WI, high signal on fluid attenuated inversion recovery (FLAIR), isointense on DWI, and signal increased on apparent diffusion coefficient (ADC) diagram. Among them, 1 case had bilateral putamen involved at the same time, showing symmetrical T1WI hypointensity, T2WI hyperintensity, FLAIR hyperintensity, restricted diffusion, increased DWI signal, and decreased ADC. The lesions disappeared in 2 cases with only brainstem and bilateral cerebellar dentate nuclei involved 1 month later; the lesions of brainstem and bilateral cerebellar dentate nuclei disappeared in 1 case with bilateral putamen involved 1 week later, and the extent of the lesions was reduced. Conclusions　Toxic encephalopathy caused by Vietnamese sophora root in children mainly involves the brainstem and bilateral cerebellar dentate nuclei, showing symmetrical and slightly longer T1WI and long T2WI signals, and bilateral basal ganglia can also be involved. Combined with clinical history, it can be used to provide useful value for early clinical identification and correct diagnosis.

Key words: Toxic encephalopathy caused by Vietnamese sophora root, Imaging features, Literature review

摘要： 目的　分析总结儿童山豆根中毒性脑病的MRI影像特征，提高对本病的认识。方法　结合相关文献，回顾性分析郑州大学附属儿童医院2015年12月至2020年4月收治的4例临床明确诊断为山豆根中毒性脑病患儿的临床资料，男2例，女2例（双胞胎姐妹），年龄5～9岁。所有病例均行MRI平扫及加扫弥散加权成像（DWI）序列，3例患儿复查，1例未复查。结果　4例病例均累及脑干、双侧小脑半球齿状核，呈对称性改变，T1WI呈等稍低信号，T2WI呈高信号，液体衰减反转恢复序列（FLAIR）呈高信号，DWI呈等信号，表观扩散系数（ADC）图信号增高，其中1例病例双侧壳核同时受累，呈对称性T1WI低信号，T2WI高信号，FLAIR高信号，弥散受限，DWI信号增高，ADC减低。2例仅累及脑干及双侧小脑齿状核的病例1个月后复查病灶消失，1例同时累及双侧壳核的病例1周后复查脑干及双侧小脑齿状核病灶消失，壳核病变范围较前减小。结论　儿童山豆根中毒性脑病以累及脑干及双侧小脑齿状核为主，呈对称性稍长T1WI长T2WI信号，双侧基底节区亦可受累，结合临床病史，可以为临床早期识别及正确诊断提供有用的价值。

关键词: 山豆根中毒性脑病, 影像特征, 文献复习