Bouhadiba Z, Dacher J, Monroc M, Vanhulle C, Ménard J F, Kalifa G
Service de Radiologie Pédiatrique, CHU Charles Nicolle, Rouen, France.
J Radiol. 2000 Aug;81(8):870-3.
To analyze the diagnostic value of MRI in children with developmental delay. Materials and Methods. From 1991 to 1997, 224 examinations were performed. Retrospective analysis of clinical findings and diagnostic yield was carried out.
MRI was abnormal in 109 cases. It never resulted in any patient care modification. 55 malformations, 12 cases of cerebral atrophy, 7 cases of white matter disease and 2 patients with phakomatose were identified. Myelination delay (26 cases), increased signal of posterior white matter on T2-weighted images (9 cases) or widened Virchow-Robin spaces (3 cases) were frequently encountered, but it remained unclear whether they represented normal variants or true abnormalities. Post ischemic lesions were identified in 10 cases. Frequency of abnormal studies was significantly lower in children with developmental delay and behavioral disorders than in patients with other clinical presentation.
Diagnostic yield of cerebral MRI can justify its performance by comparison to other imaging modalities. It should be correlated with other investigations performed in a specialized unit. Its main interest is for classification and research. Risk of sedation or anesthesia should also be taken in account. Risk can be lowered using adequately equipped MR units and organizing procedures in collaboration with anesthesiologists.
分析MRI对发育迟缓儿童的诊断价值。材料与方法。1991年至1997年期间进行了224例检查。对临床结果和诊断率进行回顾性分析。
109例MRI表现异常。但均未导致对任何患者的治疗方案改变。发现55例畸形、12例脑萎缩、7例白质病和2例错构瘤病患者。髓鞘形成延迟（26例）、T2加权图像上后白质信号增强（9例）或维氏-罗宾间隙增宽（3例）较为常见，但尚不清楚它们是代表正常变异还是真正的异常。10例发现有缺血后病变。发育迟缓和行为障碍儿童的异常检查频率明显低于其他临床表现的患者。
与其他成像方式相比，脑部MRI的诊断率证明了其应用的合理性。它应与在专门科室进行的其他检查相关联。其主要意义在于分类和研究。还应考虑镇静或麻醉的风险。使用设备齐全的MR设备并与麻醉师合作安排检查程序可降低风险。
