Objective The aim of our study was to investigate the role of three-dimensional arterial spin labeling (3D-ASL) perfusion in the diagnosis and follow-up of children with viral encephalitis. Methods Twenty-five consecutive children with viral encephalitis and 25 healthy children of similar age were recruited for the study between 2017 and 2020. Conventional magnetic resonance imaging and 3D-ASL were performed for all subjects, and a color map of cerebral blood flow (CBF) was generated. The images were classified into three groups depending on the time points at which the magnetic resonance examinations were conducted, including the initial admission scan, inpatient review, and follow-up review. Clinical, neuroradiologic, and follow-up features were studied.The CBF values of the lesion area in the diseased brain group and the bilateral temporal cortex in the control group were measured and the differences between the two groups were compared. Results Perfusion was significantly increased in the acute cerebral disease group, and CBF and normalized cerebral blood flow(nCBF) were significantly higher than in the control group (124.5 vs 70.3 mL/100 g/min, 2.85 vs 1.36). Follow-up revealed that brain tissue perfusion in the lesion area of nine children decreased gradually after treatment, as their condition improved. Conclusion Brain tissue perfusion in children with viral encephalitis increases during the acute stage and decreases when the condition improves. 3D-ASL provides a reference for diagnosis and follow-up of viral encephalitis in children.
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