Magnetic resonance imaging patterns of children with cerebral palsy: findings from hospital-based surveillance in Vietnam

Abstract

BACKGROUND: Previous studies on neuroimaging in cerebral palsy (CP) identified inconsistent radiologic findings. The Magnetic Resonance Imaging Classification system (MRICS) was developed by the Surveillance of Cerebral Palsy in Europe to standardize MRI reporting. MRICS aids in predicting future impairments and treatment but it remains largely unexplored in low-and middle-income countries (LMICs) often due to the lack of available MRI data. This study aims to document brain MRI patterns among Vietnamese children with CP. METHODS: Active prospective ascertainment of children with CP using hospital-based surveillance in the National Children’s Hospital, Hanoi, Vietnam between June and November 2017. Data on risk factors and clinical characteristics were collected. Brain MRI reports were obtained from hospital records and classified using the MRICS. RESULTS: MRI data were available for 264 children with CP (mean age 2.5±2.1 years). MRI showed pathogenic patterns in 76.4%. Nearly half (44.7%) of the children had predominant white matter injury, with predominant grey matter injury in 9.5%, and maldevelopment in 5.3%. MRI findings were associated with the type of CP and timing of causative injury including prematurity, birth asphyxia and infection. CONCLUSION: MRI findings are consistent with the predominance of white matter injury described in cohorts of children with CP from high income countries. This study furthers understanding of MRI patterns and the related aetiologic factors among children with CP in Vietnam which will inform preventive strategies in similar settings.