ROLE OF MRI BRAIN IN DIAGNOSTIC WORKUP OF CHILDREN PRESENTING WITH DELAYING MILESTONES

MRI Brain in Delayed Milestones

Abstract

Objective: To specify the value of brain MRI in the diagnostic workup of unexplained mental retardation/ delayed milestones in children.
Study Design: A descriptive study.
Place and Duration of Study: Armed Forces Institute of Radiological Imaging, Rawalpindi from, October 2013 to March 2014.
Material and Methods: This study included 100 patients of both sexes from 2-10 years of age, who presented with delayed milestones /mental retardation, where no etiological diagnosis could be made following clinical examination and preliminary investigations. MRI machine 1.5 Tesla was used.
Results: One hundred children were included in the study. Age range of patients was 2– 10 years with average age of 5.24 years (SD = 2.48). Majority of patients were males i.e. 60%. Radiological study was normal in 33% patients. Major radiological diagnosis was leukodystrophy in 30% patients followed by cerebral atrophy in 16% patients, congenital malformation in 15% patients and non specific findings in 6% patients. Comparison of radiological diagnosis between both the gender and age groups was done. It was noted that leukodystrophy occurs with equal frequency in both male and female children. However in cases of cerebral atrophy and congenital malformations males were affected more than females. In cases of cerebral atrophy 10% were female and 20% were male children. While in children with congenital malformations 3% were female and 20% were male. Age wise comparison shows that leukodystrophy is mostly seen in children between ages of 2-7 years. Whereas cerebral atrophy and congenital malformations occur a most involving all age groups.
Conclusion: MRI is an important part of the comprehensive evaluation of children with developmental delay, as many specific etiologic and pathophysiologic conditions that lead to developmental delay can be detected easily. However, children with mild neuro developmental delay frequently have normal brain MRI examination. This article is going to highlight importance of MRI as imaging modality of choice.