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Intracranial Structural Malformations in Children in Tibet: CT and MRI Findings in a Single Tertiary Center
Xuan Yin1, Dawa Ciren2, Ciren Guojie2
1Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, P.R.China.
Insights
Children
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Congenital Malformations
Background:
- Intracranial congenital or developmental malformations pose significant health challenges in pediatric populations.
- Imaging plays a crucial role in diagnosing and characterizing these complex neurological conditions.
Purpose of the Study:
- To summarize imaging findings of intracranial congenital or developmental malformations in children on the Tibetan plateau.
- To analyze the types of malformations and their associated outcomes in this specific geographic region.
Main Methods:
- Retrospective review of imaging data (CT and MRI) for suspected central nervous system (CNS) malformations.
- Inclusion of 36 pediatric patients (neonates, infants, and children) from June 2019 to June 2023.
- Consensus interpretation of imaging by two experienced radiologists.
Main Results:
- Polygyria/pachygyria and cystic cerebral changes were common congenital malformations.
- Cerebral atrophy and communicative hydrocephalus were frequent secondary CNS abnormalities.
- High rates of mortality (8 deaths) and neurological sequelae (12 cases) were observed, with 15 lost to follow-up.
Conclusions:
- Central nervous system malformations in the Tibetan Plateau are linked to substantial mortality and morbidity.
- Early and effective utilization of advanced imaging techniques is essential for timely diagnosis and management.
- Tailored treatment strategies informed by imaging findings can potentially improve patient outcomes.
Objectives:
The objective of this study was to summarize the findings of children's intracranial congenital or developmental malformations found during imaging procedures in the Tibetan plateau.
Methods:
We retrospectively reviewed the imaging data of the suspected patients who presented with the central nervous system (CNS) malformations and were enrolled either through the clinic or after ultrasound examinations between June 2019 and June 2023 in our institution. All imaging data were interpreted by two experienced radiologists through consensus reading.
Results:
In this study, we recruited 36 patients, including two neonates, 17 infants and 17 children. Seven cases underwent an MRI examination, while the others had a CT scan. Polygyria and pachygyria malformation were the most common type of congenital neurological malformations (7 cases, 31.8%), followed by cystic changes of the cerebral parenchyma (3 cases, 13.6%). Cerebral atrophy was the most common type of secondary CNS abnormality(8 cases, 57.1%), followed by communicative hydrocephalus (3 cases, 21.4%). Five patients in the congenital group and 4 patients in the secondary group had complex malformations. In the current study group, there were 8 deaths, 12 cases with neurological sequelae, 1 case with normal development, and 15 cases lost to follow-up. There were no significant differences between the primary and secondary CNS groups in terms of the outcome for both the infants and children groups.
Conclusions:
CNS malformations in the Tibetan Plateau are associated with high mortality and morbidity rates. Better utilization of imaging modalities could help design tailored treatments as early as possible.
