Related Experiment Videos
[MRI of the brain in the evaluation of children with developmental delay]
Z Bouhadiba1, J Dacher, M Monroc
1Service de Radiologie Pédiatrique, CHU Charles Nicolle, Rouen, France.
Purpose:
To analyze the diagnostic value of MRI in children with developmental delay. Materials and Methods. From 1991 to 1997, 224 examinations were performed. Retrospective analysis of clinical findings and diagnostic yield was carried out.
Results:
MRI was abnormal in 109 cases. It never resulted in any patient care modification. 55 malformations, 12 cases of cerebral atrophy, 7 cases of white matter disease and 2 patients with phakomatose were identified. Myelination delay (26 cases), increased signal of posterior white matter on T2-weighted images (9 cases) or widened Virchow-Robin spaces (3 cases) were frequently encountered, but it remained unclear whether they represented normal variants or true abnormalities. Post ischemic lesions were identified in 10 cases. Frequency of abnormal studies was significantly lower in children with developmental delay and behavioral disorders than in patients with other clinical presentation.
Conclusion:
Diagnostic yield of cerebral MRI can justify its performance by comparison to other imaging modalities. It should be correlated with other investigations performed in a specialized unit. Its main interest is for classification and research. Risk of sedation or anesthesia should also be taken in account. Risk can be lowered using adequately equipped MR units and organizing procedures in collaboration with anesthesiologists.
Insights
Magnetic Resonance Imaging (MRI) in children with developmental delay rarely altered patient care but identified abnormalities in over half of cases. Its primary value lies in classification and research, not immediate treatment decisions.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Medical Imaging
Background:
- Developmental delay in children presents a diagnostic challenge.
- Magnetic Resonance Imaging (MRI) is a key tool in neuroimaging.
- Understanding the diagnostic yield of MRI in this population is crucial.
Purpose of the Study:
- To evaluate the diagnostic value and yield of cerebral MRI in pediatric patients with developmental delay.
- To assess the impact of MRI findings on patient care and clinical management.
- To compare the utility of MRI with other imaging modalities in this context.
Main Methods:
- Retrospective analysis of 224 MRI examinations performed between 1991 and 1997.
- Correlation of MRI findings with clinical presentations and patient outcomes.
- Review of identified abnormalities, including malformations, atrophy, white matter disease, and ischemic lesions.
Main Results:
- MRI revealed abnormalities in 109 out of 224 cases (48.7%).
- No patient care modifications were directly attributed to MRI findings.
- Commonly identified abnormalities included malformations (55), cerebral atrophy (12), white matter disease (7), and post-ischemic lesions (10).
- Findings like myelination delay and increased T2 signal in white matter were frequent but often equivocal.
Conclusions:
- Cerebral MRI has a diagnostic yield that justifies its use, particularly for classification and research purposes.
- MRI findings should be interpreted in conjunction with other clinical investigations in specialized units.
- The risks associated with sedation or anesthesia for pediatric MRI necessitate careful management and planning.