Magnetic resonance imaging and proton magnetic resonance spectroscopy of the brain in the diagnostic evaluation of developmental delay |
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| Authors: | Krijn T. Verbruggen Linda C. Meiners Paul E. Sijens Roelineke J. Lunsing Francjan J. van Spronsen Oebele F. Brouwer |
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| Affiliation: | 1. Beatrix Children''s Hospital, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands;2. Department of Radiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands;3. Department of Paediatric Neurology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands;1. Department of Cardiology, St. John Hospital and Medical Center, Detroit, Michigan;2. Department of Medical Education, St. John Hospital and Medical Center, Detroit, Michigan;3. Department of Internal Medicine, St. John Hospital and Medical Center, Detroit, Michigan;4. Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina;1. Department of Radiological Science and Research Institute of Health Science, Yonsei University, Wonju, Gangwon 220-710, Republic of Korea;2. Korea Electrotechnology Research Institute (KERI), Ansan, Geongki 426-170, Republic of Korea;1. Department of Radiation Oncology, University Clinic Erlangen, Germany;2. Friedrich-Alexander-University Erlangen-Nürnberg, Germany;3. GSI Helmholtz Centre for Heavy Ion Research, Darmstadt, Germany |
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| Abstract: | AimTo assess the contribution of MRI and proton spectroscopy (1HMRS) in establishing an etiological diagnosis in children with developmental delay (DD) and to assess whether the chance of finding specific abnormalities correlates with the presence of neurological signs and/or abnormal head circumference (HC).MethodsPatients were derived from a cohort of 325 consecutive patients with DD receiving structured multidisciplinary evaluation in our centre. Patients had MRI/1HMRS if a diagnosis could not be made clinically and if additional neurological signs and/or abnormal HC and/or an IQ below 50 were present. The MRI protocol consisted of axial IR, T2, FLAIR, sagittal T1 and coronal T2 sequences. Multivoxel 1HMRS was located in a plane superior to the lateral ventricles with voxels in both grey matter and white matter.ResultsOne hundred and nine children were scanned, 80 of them because of neurological signs and/or abnormal HC. Although minor abnormalities were noted in the vast majority of patients, MRI and/or 1HMRS really contributed to an etiological diagnosis in only 10 (9%) patients, all of whom were scanned because of neurological signs. In these 10 patients, 1HMRS was diagnostic in one patient and of additional value to MRI findings in 3 patients.ConclusionsMRI and 1HMRS may contribute to the diagnostic evaluation of DD, especially if applied specifically to patients with neurological signs, whereas its role is very limited in children without these signs. |
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