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DTI of the Visual Pathway - White Matter Tracts and Cerebral Lesions
Published on: August 25, 2014
Incidental multifocal white matter lesions in pediatric magnetic resonance imaging
Naama Fisch1, Osnat Konen, Ayelet Halevy
1Department of Pediatrics A, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. naamafi@gmail.com
Insights
Pediatric white matter abnormalities found incidentally on MRI scans often have no clear cause or progression. Repeated imaging may not be beneficial, suggesting tailored follow-up based on clinical course for these unknown white matter lesions.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Neuroimaging
Background:
- White matter abnormalities of unknown cause are occasionally detected on pediatric cranial MRI.
- These incidental findings require characterization and understanding of their clinical significance.
Purpose of the Study:
- To describe the occurrence and potential significance of incidental white matter abnormalities on pediatric MRI.
- To review existing literature on this topic.
Main Methods:
- Retrospective collection of background data from medical files of 16 children.
- Classification of white matter lesions by size, location, and extent.
- Analysis of imaging findings in relation to clinical indications for MRI.
Main Results:
- White matter abnormalities were incidentally found in children undergoing MRI for various reasons, including seizures and headaches.
- No correlation was observed between lesion characteristics and clinical indications.
- Lesions showed no evident changes over time.
Conclusions:
- Incidental white matter abnormalities in children often lack a clear cause and do not progress visibly on serial imaging.
- Routine follow-up imaging may not be necessary; tailored approaches based on clinical evolution are recommended.
- Further research into incidental intracranial findings in pediatric populations is warranted.
Abstract:
This study sought to describe the occurrence and potential significance of white matter abnormalities of unknown cause on pediatric cranial magnetic resonance scans, and to review the literature. We included 16 children in whom white matter abnormalities were incidentally revealed on magnetic resonance scans performed during a 7-year period at a tertiary pediatric medical center. Background data were retrospectively collected from medical files. White matter lesions were classified by size, location, and extent. Indications for imaging included convulsive disorder (n = 5), headache (n = 5), endocrine disorder (n = 4), and others. Patients' abnormalities did not correlate with the locations and patterns of white matter lesions. No changes in lesions were evident over time. Given the absence of evident benefits from repeated imaging studies, we suggest they are not warranted in every patient, and should be tailored according to clinical course. Further investigations of incidental intracranial findings are required in this age group.
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