[Magnetic resonance imaging findings in children with cerebral palsy].

OBJECTIVE

To study the clinical and neurological abnormalities in children with cerebral palsy (CP) and to attempt to correlate the types of CP and the gestational age at birth with radiological abnormalities detected by magnetic resonance imaging (MRI) of the brain.

METHODS

This is a hospital-based study, the subjects included 104 children with cerebral palsy who were hospitalized in the Qingdao Rehibilitation Center For Disabled Children. All the 104 hospitalized CP cases (47 with spastic diplegia, 9 with tetraplegia, 15 with hemiplegia, 22 with athetosis, and 11 with ataxia) were examined neurologically and their perinatal history was reviewed. Their cranial MRI findings were studied. The association between the gestational ages, CP types, and the radiological findings were studied.

RESULTS

The type distribution was significantly different between term- and preterm- infants. Spastic diplegia was the main type in preterm infants while hemiplegia and ataxia were mainly seen in term infants. MRI abnormalities were found in 88 of the 104 cases and abnormal rates of spastic diplegia, tetraplegia, hemiplegia, athetosis, and ataxia were 89.4%, 100%, 100%, 54.5% and 90.9%, respectively. There was no significant difference in abnormal rates between term and preterm groups. Thirty-one of 42 (73.8%) children with spastic diplegia had significant periventricular leukomalacia (PVL), which was more common among preterm-born children (90%). Of the 15 children with hemiplegia, 13 had unilateral lesions on neuroimaging. Spastic tetraplegia was associated with extensive, bilateral, diffuse brain damage. The abnormalities in term-born infants with athetoid cerebral palsy were mainly located in the basal ganglia region whereas the major abnormality in premature infants was PVL. Of the 11 children with ataxic cerebral palsy, 8 cases showed congenital cerebellum dysplasia on brain imaging.

CONCLUSIONS

Radiological abnormalities of the brain were correlated with CP types and the gestational age at birth; MRI scan was useful in revealing underlying brain abnormalities and speculating on the etiology of cerebral palsy.