Yield of MRI brain imaging in children with autism spectrum disorder

Abstract

Abstract Autism spectrum disorder (ASD) is a common neurodevelopmental condition. The American Academy of Paediatrics and American Academy of Neurology do not recommend routine brain magnetic resonance imaging (MRI) in the assessment of ASD. The need for a brain MRI should be decided on atypical features in the clinical history and examination. However, many physicians continue to use MRI brain routinely in the assessment process. We performed a retrospective review of indications for requesting MRI brain in our institution over a 5-year period to determine. The aim was to was to identify the yield of MRI imaging in children with ASD and calculate the prevalence of significant neuroimaging abnormalities in children with ASD and identify clinical indications for neuroimaging One hundred and eighty-one participants were analysed. An abnormal brain MRI was identified in 7.2% (13/181). Abnormal MRI brain was more likely with an abnormal neurological examination (OR 33.1, p=0.001) or genetic/metabolic abnormality (OR 20, p=0.02). In contrast, abnormal MRI was not shown to be more likely in children with a variety of other indications such as behavioural issues and developmental delay. Thus, our findings support that MRI should not be a routine investigation in ASD, without additional findings. The decision to arrange MRI brain should be made on a case-by-case basis following careful evaluation of potential risks and benefits. The impact of any findings on the management course of the child should be considered prior to arranging imaging.