Prognostic Value of MRI in Neonates with Human Parechovirus-3 Encephalitis: A Retrospective Study

A bstract Background: Human parechovirus type 3 (HPeV-3) is an under-recognized yet significant cause of neonatal meningoencephalitis. Magnetic resonance imaging (MRI) has revealed consistent imaging patterns aiding diagnosis. Aim: To identify distinct and characteristic neuroimaging patterns in neonates with HPeV-3 encephalitis and evaluate their prognostic correlation. Settings and Design: This was a retrospective study in a tertiary care hospital. Materials and Methods: A retrospective analysis of nine neonates diagnosed with HPeV-3 encephalitis was conducted. Clinical presentations, maternal history, imaging, and outcome parameters were documented. Statistical Analysis: Logistic regression and receiver operating characteristic analysis were used to assess predictors of poor prognosis. Odds ratios (ORs) with 95% confidence intervals were computed for key clinical and radiological parameters. Results: Common MRI findings included diffusion restriction in fronto-parietal white matter, corpus callosum, and thalami. Logistic regression revealed thalamic involvement and high-risk maternal history as significant predictors of adverse outcomes (OR = 2.04). The predictive model demonstrated good accuracy with an area under the curve of 0.82. Conclusion: Distinct diffusion-weighted MRI patterns in HPeV-3 encephalitis are strong predictors of clinical outcomes. Early MRI, especially with diffusion weighted imaging sequences, is essential for diagnosis and prognosis in neonatal encephalitis.