Cerebral palsy MRI: Difference between revisions

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{{Cerebral palsy}}
{{Cerebral palsy}}


{{CMG}}; {{AE}}  
{{CMG}}; {{AE}} {{IQ}}


==Overview==
==Overview==
 
[[MRI]] is the diagnostic [[neuroimaging]] study of choice especially for older children and is preferred over [[CT scan]]. The diagnostic yield of [[MRI]] depends upon the type of CP (mixed > quadriplegic > hemiplegic > diplegic > ataxic > dyskinetic) and the timing of birth. [[MRI]] findings in patients with CP may include hypoxic-ischemic lesions (eg, [[periventricular leukomalacia]]-PVL), [[cortical]] malformations and lesions of the [[basal ganglia]].
There are no MRI findings associated with [disease name].
 
OR
 
[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].


==MRI==
==MRI==
**Diagnostic neuroimaging study of choice for older children
*[[MRI]] is the diagnostic [[neuroimaging]] study of choice especially for older children.<ref name="pmid15037681">{{cite journal |vauthors=Ashwal S, Russman BS, Blasco PA, Miller G, Sandler A, Shevell M, Stevenson R |title=Practice parameter: diagnostic assessment of the child with cerebral palsy: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society |journal=Neurology |volume=62 |issue=6 |pages=851–63 |year=2004 |pmid=15037681 |doi= |url=}}</ref><ref name="pmid1595496">{{cite journal |vauthors=Truwit CL, Barkovich AJ, Koch TK, Ferriero DM |title=Cerebral palsy: MR findings in 40 patients |journal=AJNR Am J Neuroradiol |volume=13 |issue=1 |pages=67–78 |year=1992 |pmid=1595496 |doi= |url=}}</ref><ref name="pmid7768338">{{cite journal |vauthors=Krägeloh-Mann I, Petersen D, Hagberg G, Vollmer B, Hagberg B, Michaelis R |title=Bilateral spastic cerebral palsy--MRI pathology and origin. Analysis from a representative series of 56 cases |journal=Dev Med Child Neurol |volume=37 |issue=5 |pages=379–97 |year=1995 |pmid=7768338 |doi= |url=}}</ref><ref name="pmid2739880">{{cite journal |vauthors=Miller G, Cala LA |title=Ataxic cerebral palsy--clinico-radiologic correlations |journal=Neuropediatrics |volume=20 |issue=2 |pages=84–9 |year=1989 |pmid=2739880 |doi=10.1055/s-2008-1071271 |url=}}</ref><ref name="urlBilateral lesions of thalamus and basal ganglia: origin and outcome - Krägeloh-Mann - 2007 - Developmental Medicine & Child Neurology - Wiley Online Library">{{cite web |url=http://onlinelibrary.wiley.com/doi/10.1111/j.1469-8749.2002.tb00309.x/pdf |title=Bilateral lesions of thalamus and basal ganglia: origin and outcome - Krägeloh-Mann - 2007 - Developmental Medicine & Child Neurology - Wiley Online Library |format= |work= |accessdate=}}</ref>
**Myelination for a given age
*[[MRI]] is preferred over [[CT]] due to
**A tethered spinal cord
**Higher diagnostic yield
**89% children with cerebral palsy were found to have abnormal MRIs.<ref name="pmid17018805">{{cite journal |vauthors=Bax M, Tydeman C, Flodmark O |title=Clinical and MRI correlates of cerebral palsy: the European Cerebral Palsy Study |journal=JAMA |volume=296 |issue=13 |pages=1602–8 |year=2006 |pmid=17018805 |doi=10.1001/jama.296.13.1602 |url=}}</ref>
**Role in finding out the [[etiology]] and timing of insult
**Role in predicting neurodevelopmental outcomes in preterm infants.<ref name="pmid16914704">{{cite journal |vauthors=Woodward LJ, Anderson PJ, Austin NC, Howard K, Inder TE |title=Neonatal MRI to predict neurodevelopmental outcomes in preterm infants |journal=N. Engl. J. Med. |volume=355 |issue=7 |pages=685–94 |year=2006 |pmid=16914704 |doi=10.1056/NEJMoa053792 |url=}}</ref>
*The diagnostic yield of [[MRI]] depends upon:
**May have normal results- does not exclude the diagnosis and require exclusion of metabolic and genetic etiologies
**The type of CP (mixed > quadriplegic > hemiplegic > diplegic > ataxic > dyskinetic)
**Timing of birth (scans are more often abnormal in [[preterm]] compared with term [[infants]])
*[[MRI]] findings in patients with CP include:
**Hypoxic-ischemic lesions (eg, [[periventricular leukomalacia]]-PVL)
**[[Cortical]] malformations
**Lesions of the [[basal ganglia]] (bilateral [[thalami]])
*[[MRI]] may show:
**[[Myelination]] for a given age
**A tethered [[spinal cord]]
*[[MRI]] is found to be abnormal in 90% of children with cerebral palsy.<ref name="pmid17018805">{{cite journal |vauthors=Bax M, Tydeman C, Flodmark O |title=Clinical and MRI correlates of cerebral palsy: the European Cerebral Palsy Study |journal=JAMA |volume=296 |issue=13 |pages=1602–8 |year=2006 |pmid=17018805 |doi=10.1001/jama.296.13.1602 |url=}}</ref>
*[[MRI]] has an important role in predicting neurodevelopmental outcomes in [[preterm]] [[infants]].<ref name="pmid16914704">{{cite journal |vauthors=Woodward LJ, Anderson PJ, Austin NC, Howard K, Inder TE |title=Neonatal MRI to predict neurodevelopmental outcomes in preterm infants |journal=N. Engl. J. Med. |volume=355 |issue=7 |pages=685–94 |year=2006 |pmid=16914704 |doi=10.1056/NEJMoa053792 |url=}}</ref>
*[[MRI]] may be normal in cerebral palsy- does not exclude the diagnosis and require exclusion of metabolic and genetic etiologies
[[Image:MRI_cerebral_palsy_(13).gif|300px|center|frame|'''Hyperintense lesions of bilateral thalami Axial on T-1 MRI associated with hypoxic-ischemic encephelopathy- one of the most common causes of cerebral palsy in term neonates''', source: Radiopedia.org]]


==References==
==References==

Latest revision as of 22:03, 7 October 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2]

Overview

MRI is the diagnostic neuroimaging study of choice especially for older children and is preferred over CT scan. The diagnostic yield of MRI depends upon the type of CP (mixed > quadriplegic > hemiplegic > diplegic > ataxic > dyskinetic) and the timing of birth. MRI findings in patients with CP may include hypoxic-ischemic lesions (eg, periventricular leukomalacia-PVL), cortical malformations and lesions of the basal ganglia.

MRI

  • MRI is the diagnostic neuroimaging study of choice especially for older children.[1][2][3][4][5]
  • MRI is preferred over CT due to
    • Higher diagnostic yield
    • Role in finding out the etiology and timing of insult
  • The diagnostic yield of MRI depends upon:
    • The type of CP (mixed > quadriplegic > hemiplegic > diplegic > ataxic > dyskinetic)
    • Timing of birth (scans are more often abnormal in preterm compared with term infants)
  • MRI findings in patients with CP include:
  • MRI may show:
  • MRI is found to be abnormal in 90% of children with cerebral palsy.[6]
  • MRI has an important role in predicting neurodevelopmental outcomes in preterm infants.[7]
  • MRI may be normal in cerebral palsy- does not exclude the diagnosis and require exclusion of metabolic and genetic etiologies
Hyperintense lesions of bilateral thalami Axial on T-1 MRI associated with hypoxic-ischemic encephelopathy- one of the most common causes of cerebral palsy in term neonates, source: Radiopedia.org

References

  1. ↑ Ashwal S, Russman BS, Blasco PA, Miller G, Sandler A, Shevell M, Stevenson R (2004). "Practice parameter: diagnostic assessment of the child with cerebral palsy: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society". Neurology. 62 (6): 851–63. PMID 15037681.
  2. ↑ Truwit CL, Barkovich AJ, Koch TK, Ferriero DM (1992). "Cerebral palsy: MR findings in 40 patients". AJNR Am J Neuroradiol. 13 (1): 67–78. PMID 1595496.
  3. ↑ Krägeloh-Mann I, Petersen D, Hagberg G, Vollmer B, Hagberg B, Michaelis R (1995). "Bilateral spastic cerebral palsy--MRI pathology and origin. Analysis from a representative series of 56 cases". Dev Med Child Neurol. 37 (5): 379–97. PMID 7768338.
  4. ↑ Miller G, Cala LA (1989). "Ataxic cerebral palsy--clinico-radiologic correlations". Neuropediatrics. 20 (2): 84–9. doi:10.1055/s-2008-1071271. PMID 2739880.
  5. ↑ "Bilateral lesions of thalamus and basal ganglia: origin and outcome - Krägeloh-Mann - 2007 - Developmental Medicine & Child Neurology - Wiley Online Library".
  6. ↑ Bax M, Tydeman C, Flodmark O (2006). "Clinical and MRI correlates of cerebral palsy: the European Cerebral Palsy Study". JAMA. 296 (13): 1602–8. doi:10.1001/jama.296.13.1602. PMID 17018805.
  7. ↑ Woodward LJ, Anderson PJ, Austin NC, Howard K, Inder TE (2006). "Neonatal MRI to predict neurodevelopmental outcomes in preterm infants". N. Engl. J. Med. 355 (7): 685–94. doi:10.1056/NEJMoa053792. PMID 16914704.

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