Reply:

We thank Drs Velonakis, Karavasilis, Almyroudi, Filippiadis, and Korompoki for the in-depth commentary on our article. We value the important observations they made regarding the differences in the rates of leptomeningeal contrast enhancement in patients with coronavirus disease 2019 among the included articles in our review. We agree that the large range may be in part because of the differences in MR imaging protocols. It is reasonable to assume that institutions using MR imaging sequences that are more sensitive for detecting leptomeningeal contrast enhancement would report more of it. Because the data included in our article came from around the world, another possibility for the great variability of neuroimaging findings, including leptomeningeal contrast enhancement, may be because of differences in patient population, disease severity, geographic location, and genetic variations of Severe Acute Respiratory Syndrome coronavirus 2. More research is needed to account for all of the clinical and imaging presentations of this protean disease in the central nervous system.

• © 2021 by American Journal of Neuroradiology