MRI-Based Radiologic Scoring System for Extent of Brain Injury in Children with Hemiplegia

作者：Shiran S I^*; Weinstein M; Sirota Cohen C; Myers V; Ben Bashat D; Fattal Valevski A; Green D; Schertz M

来源：American Journal of Neuroradiology, 2014, 35(12): 2388-2396.

DOI：10.3174/ajnr.A3950

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. %26lt;br%26gt;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%26apos;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. %26lt;br%26gt;RESULTS: Mean total radiologic score was 11.3 +/- 4.5 (range 4-18). Good inter- (rho = 0.909, P %26lt; .001) and intrarater (rho = 0.926, P %26lt; .001) reliability was demonstrated. Radiologic score correlated significantly with manual ability classification systems (rho = 0.708, P %26lt; .001), and with motor assessments (assisting hand assessment [rho = -0.753, P %26lt; .001]; Jebsen Taylor test of hand function [rho = 0. 766, P %26lt; .001]; children%26apos;s hand experience questionnaire [rho = -0.716, P %26lt; .001]), as well as with DTI parameters. %26lt;br%26gt;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.

• 出版日期2014-12