ROLE OF MAGNETIC RESONANCE IMAGING OF BRAIN IN DEVELOPMENTAL DELAY IN CHILDREN

Introduction: Global developmental delay is diagnosed when there is a significant delay in two or more of the following domains of development: Gross motor, fine motor, speech and language, cognition, and social/ personal development. There are several etiological processes that can hinder the process of developmental of brain in a child such as neurovascular insult, metabolic, toxic and congenital causes among many leading to significant delay in attaining developmental milestones.

Objectives: The purpose of this study is to identify the spectrum of abnormalities of the brain in children presenting with developmental delay on MRI and further categorize the morphological abnormalities.

Materials and methods: Our study included 60 children of both the sexes and age group ranging from 3 months to 12 years with clinical diagnosis of developmental delay referred for brain MRI from the department of paediatrics for a period of one year.

Result: Out of the 60 cases enrolled in the study, 17 (28.3%) patients had normal MRI brain and 43 (71.7%) had abnormal MRI brain findings. The highest number of patients with abnormal MRI brain was found in the age group 3 months-11 months which constituted of 22 patients, followed by age group 1 year–4 years where abnormal brain MRI were found in 15 patients. Out of the total 60 cases, 35 (58.3%) patients had history of term delivery whereas 25 (41.7%) patients had history of preterm delivery. Among the 25 children with history of preterm delivery, 3 (12%) had normal MRI brain finding whereas 22 (88%) had abnormal brain MRI findings. Among the 35 children with history of term delivery, 14 (40%) had normal MRI brain whereas 21 (60%) had abnormal MRI brain findings. Significant association between the gestational age and MRI findings was observed (p<0.05). Among the 43 cases with abnormal MRI brain findings, 33 (53.4%) had findings consistent with neurovascular disease, 9 (15%) cases had congenital anomalies and 2 (3.3%) cases had findings consistent with metabolic disorder. The abnormalities of the ventricles were seen in 25 (41.7%) patients, white matter in 29 patients (48.3%), gray matter in 19 (31.7%) patients, corpus callosum in 20 (33.3%) patients, cerebellum in 6 (10%) patients, basal ganglia in 1 (1.7%) patient and hippocampus in 1 (1.7%) patient.

Conclusion: The MRI brain has been found to be a useful radiological investigation in evaluating a child with developmental delay because it not only allows for a comprehensive assessment of the anatomical detail of the brain, but it also provides an etiological basis for a child with developmental delay, which aids the clinician in providing treatment to the patient and providing counseling to the parents.

Author(s): Dibyajyoti Nath, Aabir Hazarika* and Pranjit Thapa

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