THE VALUE OF COMPUTED
TOMOGRAFI (CT-SCAN) AND MAGNETIC RESONANCE IMAGING (MRI) IN INVESTIGATION
OF CHILDREN IN A HABILITATION UNIT
Ljunggren CG
Vrinnevi Hospital,
Norrkoping, Sweden
Objective:
Are CT-scan and MRI useful tools in investigation of children in a
habilitation unit?
Method:
Retrospective study of the results of radiological examinations of 67
children referred for neurological investigation at the Habilitation Unit
of Norrkoping. CT-scan and
particularly MRI are expensive and time consuming procedures, that could be
extremely valuable in selected cases. In clinical praxis and when
cost-benefit has to be taken into account one has to select carefully those
cases that benefit from such investigations.
Results: Of the 600 children and teenagers
belonging to the unit, 67 have so far been evaluated. The clinical
diagnosis was grouped into three major fields. 1) Cp syndromes 2) Mental
retardation 3) Neuro-psyciatric disorders (ADHD/DAMP, Autism/Aspberger). In
categori 1: 18 of 21 had positive signs on CT-scan or MRI (Ataxi 2/2,
spastic diplegia 3/6, tetraplegia 2/2, hemiplegia 11/11). In categori 2: 19
of 37 had positive signs (mild MR 6/20, moderate MR 5/8, severe MR 8/9. In
categori 3: 2 of 9 had positive signs (DAMP 1, Autism 1).
Conclusion: Not surprisingly positive results
on CT-scan and MRI can be exspected in children with Cp and severe MR.
Surprisingly there were also many positive findings in mild and moderate
MR. On the other hand very few investigations led to further
considerations. Thus CT-scan and MRI should be reserved for those cases of
cerebral diseases. The etiology can not be clarified in other ways (e.g.
many neurodegenerative diseases and malformation disorders) or treatment
could be influenced for instance in cerebral tumor or intractable epilepsy
where surgery could be an important way of treatment.