Magnetic Resonance Imaging of Inflammatory and Demyelinating White‐matter Diseases of Childhood

Abstract

SUMMARY Magnetic resonance imaging (MRI) was performed on 36 children and two adults (with clinical presentation during childhood) with white‐matter disease of the central nervous system. Abnormalities were readily demonstrated in patients with multiple sclerosis, acute disseminated encephalomyelitis, leucodystrophies and subacute sclerosing panencephalitis: MRI demonstrated the extent and distribution of abnormalities more clearly than computed tomography for all these disorders. The abnormalities tended to be asymmetrical and multifocal in multiple sclerosis and acute disseminated encephalomyelitis, and more confluent and symmetrical in the leucodystrophies. Children with clinically isolated optic neuritis had a significantly lower frequency of MRI brain‐lesions than adults with the same disorder. MRI should be regarded as the radiological investigation of choice when white‐matter disease is suspected in children. RÉSUMÉ Imagerie de résonance magnétique des affections inflammatoires et démyélinisantes de la substance blanche de l'enfance Une imagerie de résonance magnétique (IRM) a été effectuée chez 36 enfants et deux adultes (avec manifestations cliniques durant l'enfance), ayant présenté une affection de la substance blanche du système nerveux central. L'existence d'anomalies a été facilement démontrée en cas de sclérose en plaques, d'encéphalite aiguë disséminée, de leucodystrophie et de panencéphalite sclérosante subaiguë: l'IRM révélait l'étendue et la distribution des anomalies plus clairment que le scanner dans toutes ces affections. Les anomalies tendaient à être assymétriques et multifocals dans la sclérose en plaques et l'encéphalomyélite aiguë disséminée, plus regroupées et symétriques dans les leucodystrophies. Les enfants porteurs d'une névrite optique isolée avaient une fréquence de lésions cérébrales à l'IRM plus faible que les adultes atteints du même trouble. L'IRM doit être considérée comme l'exploration radiologique de choix lorsqu'une affection de la substance blanche est suspectée chez l'enfant. ZUSAMMENFASSUNG Kernspinntomographie bei entzüdlichen und demyelinisierenden Erkrankungen der weißen Substanz in Kindesalter Bei 36 Kindern und zwei Erwachsensen mit einer Erkrankung der weißen Substanz des Zentralnervensystems wurde eine Kernspinntomographie durchgeführt (MRI). Die beiden Erwachsenen hatten schon während des Kindesalters erste klinische Symptome gezeigt. Bei Patienten mit Multipler Sklerose, akuter Encephalomyelitis disseminata, Leukodystrophien und subakuter sklerosierender Panencephalitis wurden abnorme Befunde nachgewiesen: Im MRI wurden Aussdehnung und Verteilung der abnormen Befunde für all diese Erkrankungen klarer dargestellt als im Computertomogramm. Die abnormen Befunde waren bei der Multiplen Sklerose und der akuten Encephalitis disseminata eher asymmetrisch und multifokal und bei den Leukodystrophien mehr konfluierend und symmetrisch. Kinder mit einer klinisch isolierten Opticusneuritis hatten signifikant seltener Hirnläsionen im MRI als Erwachsene mit derselben Erkrank...

Clinical and diagnostic aspects of multiple sclerosis and acute monophasic encephalomyelitis in pediatric patients: a single centre prospective study

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