Abstract: Objective  To explore the difference in MRI manifestations between reversible splenial lesion syndrome(RESLES) and cerebral infarction in adults, and to analyze the prognostic value of MRI. 
Methods  We selected 21 patients with RESLES and 39 patients with infarction as the research subjects. The location, morphology and imaging characteristics of the lesions in the MRI imaging of the two groups were recorded, and the differences in MRI imaging data of the two groups were analyzed. 
Results  The lesions of 21 RESLES patients were concentrated on the midline of the corpus callosum, symmetrically distributed around the midline position, and all were isolated and circular-like signal images, including 10 cases of circular signals, 8 cases of elliptical signals and 3 cases of fusiform signal. MRI plain scan revealed slightly low signal on T1-weighted imaging(T1WI), slightly higher signal on T2-weighted imaging(T2WI), slightly higher signal on MRI fluid attenuated inversion recovery(FLAIR) sequence, significant high signal on diffusion weighted image(DWI); low signal intensity on apparent diffusion coefficient(ADC) map, with an average value of(0.407 2±0.099 5)×10-3 mm2/s; average maximum cross-sectional area of the lesion was(95.86±7.05) mm2. MRI reexamination interval was 8-30 d. After treatment, imaging examinations of all patients showed the lesions were practically eliminated. Among them, there were 37 patients with cerebral infarction combined with other brain lesions, 36 cases of splenial lesions were single lesions, 3 cases of splenial lesions with multiple lesions, and the lesions were mostly slices, strips or in irregular shapes. Imaging examination showed high signal on DWI, the average ADC was(0.431 6±0.010 4)×10-3 mm2/s, and the average maximum cross-sectional area of the lesion was(100.06±21.84) mm2. There was no statistical difference in ADC values between the two groups(P＞0.05). 
Conclusion  The MRI imaging features of patients with RESLES and corpus callosum infarction showed that the relationship between the lesion and the midline of the corpus callosum and the shape of the lesion could be used as an effective means to differentiate the two diseases, and that the presence or absence of other lesions in the brain could be used for auxiliary identification. In this study, there was no significant difference in the ADC value in patients of the two groups. Further analysis is needed to confirm whether it is valuable for differential diagnosis of the disease. 

Key words: brain infarctio； splenial lesion syndrome, magnetic resonance imaging