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MRI-based radiologic scoring system for extent of brain injury in children with hemiplegia
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2014 (English)In: American Journal of Neuroradiology, ISSN 0195-6108, E-ISSN 1936-959X, Vol. 35, no 12, p. 2388-2396Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND PURPOSE:

Brain MR imaging is recommended in children with cerebral palsy. Descriptions of MR imaging findings lack uniformity, due to the absence of a validated quantitative approach. We developed a quantitative scoring method for brain injury based on anatomic MR imaging and examined the reliability and validity in correlation to motor function in children with hemiplegia.

MATERIALS AND METHODS:

Twenty-seven children with hemiplegia underwent MR imaging (T1, T2-weighted sequences, DTI) and motor assessment (Manual Ability Classification System, Gross Motor Functional Classification System, Assisting Hand Assessment, Jebsen Taylor Test of Hand Function, and Children's Hand Experience Questionnaire). A scoring system devised in our center was applied to all scans. Radiologic score covered 4 domains: number of affected lobes, volume and type of white matter injury, extent of gray matter damage, and major white matter tract injury. Inter- and intrarater reliability was evaluated and the relationship between radiologic score and motor assessments determined.

RESULTS:

Mean total radiologic score was 11.3 ± 4.5 (range 4 -18). Good inter- (p = 0.909, P < .001) and intrarater (p = 0.926, P =<.001) reliability was demonstrated. Radiologic score correlated significantly with manual ability classification systems (p = 0.708, P < .001), and with motor assessments (assisting hand assessment [p = <0.753, P < .001]; Jebsen Taylor test of hand function [p = 0. 766, P < .001]; children's hand experience questionnaire [p=<0. 716, P < .001]), as well as with DTI parameters.

CONCLUSIONS:

We present a novel MR imaging- based scoring system that demonstrated high inter- and intrarater reliability and significant associations with manual ability classification systems and motor evaluations. This score provides a standardized radiologic assessment of brain injury extent in hemiplegic patients with predominantly unilateral injury, allowing comparison between groups, and providing an additional tool for counseling families.

Place, publisher, year, edition, pages
American Society of Neuroradiology , 2014. Vol. 35, no 12, p. 2388-2396
Keywords [en]
adolescent, adult, Article, assessment of humans, assisting hand assessment, brain injury, child, children hand experience questionnaire, clinical article, cohort analysis, diffusion tensor imaging, female, gray matter, Gross Motor Function Classification System, hemiplegia, human, intrarater reliability, jebsen taylor test of hand function, male, manual ability classification system, motor performance, nuclear magnetic resonance imaging, nuclear magnetic resonance scanner, quantitative analysis, scoring system, validity, white matter injury, Brain Injuries, classification, neurologic examination, procedures, Humans, Magnetic Resonance Imaging
National Category
Neurology
Identifiers
URN: urn:nbn:se:hj:diva-37450DOI: 10.3174/ajnr.A3950ISI: 000346690500029PubMedID: 24852291Scopus ID: 2-s2.0-84919475239OAI: oai:DiVA.org:hj-37450DiVA, id: diva2:1146198
Available from: 2017-10-02 Created: 2017-10-02 Last updated: 2017-10-02Bibliographically approved

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