Panencephalitis in pediatric patients represents a group of severe diffuse inflammatory brain disorders characterized by widespread involvement of both gray and white matter, often leading to significant neurological impairment and high morbidity. Early and accurate diagnosis remains a major clinical challenge due to heterogeneous etiology, variable clinical presentation, and overlapping imaging features with other diffuse encephalopathies. Magnetic resonance imaging has become the cornerstone of neuroimaging in suspected panencephalitis, with recent advances significantly expanding its diagnostic capabilities. Modern MRI techniques, including diffusion-weighted imaging, fluid-attenuated inversion recovery, susceptibility-weighted imaging, and advanced modalities such as perfusion imaging and MR spectroscopy, provide valuable insights into tissue structure, inflammatory activity, and metabolic alterations. This review aims to evaluate the role of contemporary MRI techniques in the diagnosis of pediatric panencephalitis, with emphasis on their diagnostic value, limitations, and integration into clinical practice. Particular attention is given to the differentiation of infectious, autoimmune, and post-infectious forms, as well as to the challenges of early-stage detection. Available evidence suggests that while conventional MRI sequences remain essential for detecting structural abnormalities, advanced techniques improve sensitivity in early disease stages and contribute to more accurate differential diagnosis. However, interpretation remains complex due to nonspecific findings and variability of imaging patterns across different etiologies. Modern MRI should therefore be considered a multimodal diagnostic platform rather than a single imaging method. Its optimal use requires integration with clinical, laboratory, and immunological data to improve diagnostic accuracy and guide patient management.

Panencephalitis, pediatric neuroimaging, diffusion-weighted imaging

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