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Brain magnetic resonance imaging in congenital hypothyroid infants at diagnosis
V Siragusa1, S Boffelli, G Weber
1Department of Pediatrics, Scientific Institute H San Raffaele, University of Milan, Italy.
Insights
Congenital hypothyroidism (CH) in infants, detected early, showed no central nervous system (CNS) brain abnormalities or myelination differences on MRI scans before treatment. This suggests perinatal hypothyroidism does not impact early brain development.
Area of Science:
- Pediatric Endocrinology
- Neuroimaging
- Neonatal Medicine
Background:
- Congenital hypothyroidism (CH) is a condition requiring early intervention.
- The impact of untreated CH on central nervous system (CNS) development is a critical concern.
- Neonatal screening enables early detection of CH before significant clinical manifestations.
Purpose of the Study:
- To evaluate the CNS morphology and myelination in infants with CH using MRI.
- To assess brain development in CH infants identified by neonatal screening prior to thyroid hormone replacement therapy.
Main Methods:
- Magnetic Resonance Imaging (MRI) was performed on 11 CH infants (mean age 22 days) and 22 healthy term newborns.
- Utilized a 1.5-T magnet with an extremity coil, acquiring T1-weighted and heavily T2-weighted axial sequences.
- No sedation was required for the MRI examinations.
Main Results:
- All CH infants exhibited normal MRI brain examinations compared to controls.
- No significant differences in brain myelination patterns were observed between CH infants and normal subjects.
- No morphological brain abnormalities were detected in CH infants before treatment initiation.
Conclusions:
- Early detected congenital hypothyroidism does not appear to cause morphological brain abnormalities.
- Perinatal hypothyroidism, when identified by screening, may not affect CNS structures or myelination.
- Neonatal screening for CH allows for timely intervention without apparent compromise to early brain development.
Abstract:
The aim of our study was to investigate the central nervous system (CNS) morphology and myelination with magnetic resonance imaging (MRI) in congenital hypothyroid (CH) infants detected by neonatal screening before replacement therapy. We studied 11 CH infants, 9 girls and 2 boys, mean age 22 days, 3 with aplasia, 5 with ectopia, 2 with hypoplasia of the thyroid gland, 1 with unknown diagnosis. As normal controls 22 term newborns (38 to 41 weeks of gestational age) were studied. MRI studies were performed with a 1.5-T magnet, extremity coil, T1-weighted and heavily T2-sequences axial sections were obtained. No sedation was needed for the MRI studies. MRI brain examination was normal in all patients compared with controls. In particular, no differences in the myelination patterns of the brain were observed between normal subjects and patients with hypothyroidism. Our study shows no morphological brain abnormalities in CH infants detected by neonatal screening before replacement therapy. Perinatal hypothyroidism seems to have no effect on CNS structures.