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 | [[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== | ||
*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> | *[[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> | ||
*MRI is preferred over CT due to | *[[MRI]] is preferred over [[CT]] due to | ||
**Higher diagnostic yield | **Higher diagnostic yield | ||
**Role in finding out the etiology and timing of insult | **Role in finding out the [[etiology]] and timing of insult | ||
*The diagnostic yield of MRI depends upon: | *The diagnostic yield of [[MRI]] depends upon: | ||
**The type of CP (mixed > quadriplegic > hemiplegic > diplegic > ataxic > dyskinetic) | **The type of CP (mixed > quadriplegic > hemiplegic > diplegic > ataxic > dyskinetic) | ||
**Timing of birth (scans are more often abnormal in preterm compared with term infants) | **Timing of birth (scans are more often abnormal in [[preterm]] compared with term [[infants]]) | ||
*MRI findings in patients with CP include: | *[[MRI]] findings in patients with CP include: | ||
**Hypoxic-ischemic lesions (eg, periventricular leukomalacia | **Hypoxic-ischemic lesions (eg, [[periventricular leukomalacia]]-PVL) | ||
**Cortical malformations | **[[Cortical]] malformations | ||
**Lesions of the basal ganglia (bilateral [[thalami]]) | **Lesions of the [[basal ganglia]] (bilateral [[thalami]]) | ||
*MRI may show: | *[[MRI]] may show: | ||
**Myelination for a given age | **[[Myelination]] for a given age | ||
**A tethered spinal cord | **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]] 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]] 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 | *[[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]] | [[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]] | ||
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:
- 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.[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
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References
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ Miller G, Cala LA (1989). "Ataxic cerebral palsy--clinico-radiologic correlations". Neuropediatrics. 20 (2): 84–9. doi:10.1055/s-2008-1071271. PMID 2739880.
- ↑ "Bilateral lesions of thalamus and basal ganglia: origin and outcome - Krägeloh-Mann - 2007 - Developmental Medicine & Child Neurology - Wiley Online Library".
- ↑ 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.
- ↑ 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.