Publication:

Neuroimaging in paediatric patients with developmental delay

Background Aim and objectives of the study were to radiologically evaluate paediatric patients with developmental delay (DD), assess the relative prevalence of abnormal brain MRI, further categorize them based on the abnormal imaging findings and structures affected. The purpose of this study is to diagnose the underlying etiology that helps in early treatment and amelioration of the condition, parental counselling regarding the outcome of the child, providing an estimate of child’s developmental potential and the recurrence risk in siblings.

Methods 135 paediatric patients of the age 3 months to 15 years with DD referred to department of radiology were investigated with MRI scans of the brain via 1.5T Siemens scanner after making the child sleep or sedated. The sequences used were: axial T1, axial T2, axial FLAIR, axial DWI, axial ADC, axial SWI, axial PHASE, sagittal T1 and coronal FLAIR. CT scan of the brain was done only when indicated on 128 slice Siemens Somatom perspective scanner. Informed consent shall be taken from patient’s parents. Clinical and demographic details of the enrolled patients were noted in the Performa. Data collected was analysed using descriptive and inferential statistics.

Results Out of 135 children with DD, 69.1% (n=92) were male and 31.9% (n=43) were female. Majority of these children belonged to 3 months to 1 year and 2 to 5 years of age group. About 81.4% (n=110) of children with DD had abnormal findings in MRI. Among children with abnormal MRI findings, 42.9% had hypoxic ischemic changes, 6.6% had congenital malformations and non-specific causes, respectively 4.4% had neurodegenerative and occlusive neurovascular conditions, respectively 3.7% had CSF disorders and neoplasms, respectively 2.9% had infection associated changes and non-traumatic intracranial bleed, respectively 2.2% had metabolic disorders and 0.7% had demyelination. Majority of cases had ventricular abnormality, followed by the corpus callosum.

Conclusions DD presents with a wide spectrum of etiologies, clinical findings and MRI features ranging from completely normal to abnormal. The present study could establish the various morphological appearances of DD on MRI and further categorize them into various subgroups be effective in diagnosis, management and prognosis determination processes.