"Advanced MRI Insights into Brain Abnormalities in Children with Developmental Delay: A Clinico-Radiological Approach"

Abstract

Background: Developmental delay is characterized by a significant lag in one or more developmental domains, with an estimated global prevalence of 1-3%. Magnetic resonance imaging (MRI) serves as a crucial neuroimaging modality for assessing and diagnosing developmental delay disorders in children.

Aims and Objectives: This study aimed to evaluate the spectrum of brain abnormalities in children with developmental delay using MRI and categorize the identified morphological abnormalities. Additionally, the study explored the role of magnetic resonance spectroscopy (MRS) in assessing neurometabolite ratio variations in children with normal MRI findings.

Materials and Methods: A total of 100 children with developmental delay were examined at the Department of Radiodiagnosis, during June 2023 to May 2024 at Apollo Institute Of Medical Sciences & Research Chittoor, Murakambattu , Chittoor, Andhra Pradesh. MRI scans were performed using a standardized protocol, and clinical as well as demographic data were recorded. Various brain structures were systematically assessed, and morphological abnormalities were classified.

Results: Results: The highest prevalence of developmental delay was observed in the 3-6 years age group (51%), with a male-to-female ratio of 1:1.4. MRI abnormalities were detected in 73% of cases, with a higher frequency in younger children. The presence of seizures strongly correlated with abnormal MRI findings (90.7%, p<0.001). Additionally, 82.1% of children with developmental delay plus other clinical features had abnormal MRI findings, compared to 40.9% in those with isolated developmental delay. Neurovascular abnormalities were the most common MRI finding (48%), followed by congenital and developmental anomalies (14%). The highest incidence of neurovascular conditions was noted in the 3-6 years age group (67%), reinforcing early childhood as a critical period for detection and intervention.

Conclusion: MRI exhibits high sensitivity and specificity in diagnosing developmental delay-related disorders, facilitating the identification of potential etiologies in most cases. Proton MR spectroscopy is a valuable complementary technique for evaluating developmental delay and should be incorporated into standard MRI protocols where applicable. Accurate MRI-based diagnosis aids clinicians in devising appropriate management plans for affected children.