The prevalence and spectrum of brain MRI findings among children with developmental delay at selected hospitals in Kampala

Abstract

Background: Developmental delay denotes significant delay in one or more developmental domains. In children ages 3–17 years, the global burden of developmental delay is ~1 to 3%. Brain Magnetic Resonance Imaging (MRI) provides a high diagnostic yield in the evaluation of patients with developmental delay. Objective: This study was aimed to determine the prevalence and spectrum of brain MRI findings in children with developmental delay at selected hospitals in Kampala, Uganda. Methods: This was a retrospective study of brain MRI for children aged between six months and 14 years, with a diagnosis of developmental delay at the selected hospitals in Kampala. Participants were identified from the registry at the selected hospitals, their images retrieved and interpreted from the PACS system. Results: One hundred and twenty-two images were included in our study, 81 (66%) were males and 41 females (34%). Their average age was 4 years (Range: 0.5 - 14), standard deviation (SD) +/- 3.5 years. The most common conditions prompting brain imaging were gross developmental (58 [48%]), developmental delay and epilepsy (24 [20%]) and delay in milestones (20 [16%]). Others were speech delay (11(9%)), abnormal movements (7(6%)), intellectual disability (6(5%)), abnormal head size (4(3%)), behavioral challenge (3(2%)) and those with gait abnormalities (3(2%)). The prevalence of abnormal MRI findings was 72%. The abnormal findings included grey matter (65%), white matter (56%), corpus callosum (56%), and ventricular system (55%), basal ganglia (24%), nonspecific 15%, cerebellum 13%, and brainstem 6%. Specific abnormalities included neurodevelopmental disorders like grey matter heterotopia and lissencephaly, white matter hyperintensities, corpus callosum hypoplasia/agenesis, and ventriculomegaly. Age (0.013), abnormal movement (0.023), motor delay (0.057), chromosomal and dysmorphic features (0.106) were significant predictors of abnormal MRI in children with developmental delay in our study. Conclusion: The majority of brain MR images were abnormal with a prevalence of 72%, comprising of grey matter, white matter, corpus callosum, and ventricular system structural anomalies. Therefore, Brain MRI is a valuable tool for early diagnosis of children with DD.