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Isolated neurodevelopmental delay in childhood: clinicoradiological correlation in 170 patients
P Demaerel1, D P Kingsley, B E Kendall
1Department of Neuroradiology, Hospital for Sick Children, London, UK.
Abstract:
CT findings on 170 patients presenting with isolated moderate to severe neurodevelopmental delay have been compared with the final diagnosis. MRI was undertaken in 29 patients. Eighty per cent of the patients remained undiagnosed, and although the MRI findings were abnormal in 65.5% compared with only 30% of the CT examinations, imaging uncommonly suggested a specific diagnosis. Biochemical and chromosomal investigations were significantly more diagnostic. The results of these studies should restrict the number of non-contributory neuroradiological examinations. The superior intrinsic contrast of MRI will detect more lesions, particularly in white matter, but these are rarely diagnostic and where access to MRI is limited, CT is usually adequate.
Insights
Neuroimaging, including CT and MRI, rarely diagnoses the cause of neurodevelopmental delay. Biochemical and chromosomal tests are more effective for diagnosis, suggesting fewer imaging studies are needed.
Area of Science:
- Neurology
- Radiology
- Genetics
Background:
- Neurodevelopmental delay (NDD) is a complex condition often requiring extensive diagnostic workups.
- The role of neuroimaging, specifically Computed Tomography (CT) and Magnetic Resonance Imaging (MRI), in diagnosing the etiology of NDD is under investigation.
Purpose of the Study:
- To evaluate the diagnostic yield of CT and MRI in patients with isolated moderate to severe neurodevelopmental delay.
- To compare the effectiveness of neuroimaging with biochemical and chromosomal investigations in identifying the cause of NDD.
Main Methods:
- Retrospective analysis of CT findings in 170 patients with moderate to severe neurodevelopmental delay.
- MRI was performed in 29 of these patients.
- Comparison of imaging results with final diagnoses, including biochemical and chromosomal analyses.
Main Results:
- Eighty percent of patients remained undiagnosed by imaging.
- MRI detected abnormalities in 65.5% of cases, compared to 30% with CT.
- Despite detecting more lesions, imaging rarely suggested a specific diagnosis.
- Biochemical and chromosomal investigations proved significantly more diagnostic.
Conclusions:
- Neuroimaging studies (CT and MRI) have a limited role in diagnosing the cause of moderate to severe neurodevelopmental delay.
- Biochemical and chromosomal analyses are more effective diagnostic tools for NDD.
- The findings suggest a need to restrict non-contributory neuroradiological examinations in cases of NDD.