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Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure
Published on: July 30, 2009
MRI in children with mental retardation
Gustavo Soto-Ares1, Béatrice Joyes, Marie-Pierre Lemaître
1Department of Neuroradiology, Hôpital Roger Salengro, CHRU Lille, 59037 Lille, France. gsotoares@chru-lille.fr
Background:
In mental retardation (MR) an aetiological diagnosis is not always obtained despite a detailed history, physical examination and metabolic or genetic investigations. In some of these patients, MRI is recommended and may identify subtle abnormal brain findings.
Objective:
We reviewed the cerebral MRI of children with non-specific mental retardation in an attempt to establish a neuroanatomical picture of this disorder.
Materials And Methods:
Thirty children with non-specific MR were selected to undergo cerebral MRI. The examination included supratentorial axial slices, mid-sagittal images and posterior fossa coronal images. Brain malformations, midline and cerebellar abnormalities were studied.
Results:
In 27 of 30 patients, the neuroimaging evaluation revealed a relatively high incidence of cerebral and posterior fossa abnormalities. The most frequent were: dysplasia of the corpus callosum (46%; hypoplasia, short corpus callosum and vertical splenium), partially opened septum pellucidum and/or cavum vergae (33%), ventriculomegaly (33%), cerebral cortical dysplasia (23%), subarachnoid space enlargement (16.6%), vermian hypoplasia (33%), cerebellar and/or vermian disorganised folia (20%), and subarachnoid spaces enlargement in the posterior fossa (20%). Other anomalies were: enlarged Virchow-Robin spaces (10%), white matter anomalies (10%) and cerebellar or vermian atrophy.
Conclusions:
MRI has shown a high incidence of subtle cerebral abnormalities and unexpected minor forms of cerebellar cortical dysplasia. Even if most of these abnormalities are considered as subtle markers of brain dysgenesis, their role in the pathogenesis of mental retardation needs further investigation.
Insights
Cerebral MRI reveals subtle brain abnormalities in children with unexplained mental retardation (MR). These findings, including corpus callosum dysplasia and cerebellar abnormalities, suggest brain dysgenesis as a potential cause requiring further study.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- Genetics
Background:
- A definitive diagnosis for mental retardation (MR) is often elusive despite comprehensive evaluations.
- Neuroimaging, specifically Magnetic Resonance Imaging (MRI), can reveal subtle brain abnormalities in such cases.
Purpose of the Study:
- To investigate the neuroanatomical findings in children with non-specific mental retardation using cerebral MRI.
- To establish a neuroanatomical profile associated with unexplained intellectual disability.
Main Methods:
- Cerebral MRI scans were performed on 30 children diagnosed with non-specific mental retardation.
- The MRI protocol included supratentorial axial, mid-sagittal, and posterior fossa coronal views.
- Analysis focused on identifying brain malformations, midline abnormalities, and cerebellar structural variations.
Main Results:
- Abnormalities were detected in 27 out of 30 patients, indicating a high incidence of cerebral and posterior fossa findings.
- Common abnormalities included corpus callosum dysplasia (46%), partially opened septum pellucidum/cavum vergae (33%), ventriculomegaly (33%), and vermian hypoplasia (33%).
- Other frequent findings were cerebral cortical dysplasia (23%), enlarged subarachnoid spaces (16.6%), and disorganized cerebellar folia (20%).
Conclusions:
- Cerebral MRI demonstrates a significant prevalence of subtle brain abnormalities and cerebellar cortical dysplasia in children with unexplained mental retardation.
- These findings suggest potential markers of brain dysgenesis contributing to intellectual disability.
- Further research is necessary to elucidate the precise role of these neuroanatomical abnormalities in the pathogenesis of mental retardation.
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