MRI classification system (MRICS) for children with cerebral palsy: development, reliability, and recommendations

Area of Science:

• Neurology
• Pediatrics
• Radiology

Background:

• Cerebral palsy (CP) diagnosis relies on clinical assessment and neuroimaging.
• Standardized classification of MRI findings in children with CP is needed for accurate data in CP registers.

Purpose of the Study:

• To develop and evaluate a classification system for magnetic resonance imaging (MRI) findings in children with CP.
• To create a tool suitable for implementation in CP registers.

Main Methods:

• Developed the MRI Classification System (MRICS) based on pathogenic patterns across brain development stages.
• Created a detailed manual with test cases for MRICS.
• Assessed MRICS applicability and interrater reliability through an exercise with 41 professionals classifying MRIs or MRI reports.

Main Results:

• MRICS demonstrated good overall interrater reliability (k=0.69).
• Interrater reliability was very good when using MRI reports (k=0.81).
• Existing classification systems were found to be compatible with MRICS, allowing for harmonization.

Conclusions:

• The MRICS is proposed by the Surveillance of Cerebral Palsy in Europe (SCPE) as a reliable tool.
• The MRICS, with its manual, is simple to apply for CP registers, enhancing surveillance efforts.