Key result
A higher multi-parametric MRI score was associated with poorer clinical outcomes in children with acute necrotizing encephalopathy, demonstrating a positive correlation (r=0.1198) between the score and outcome severity.
Why the study?
Acute necrotizing encephalopathy of children carries a poor prognosis with high morbidity and mortality, prompting investigation into whether multi-parametric MRI findings and MRI scoring correlate with clinical outcomes.
Does multi-parametric MRI scoring correlate with clinical outcomes in children with acute necrotizing encephalopathy?
Observational (n=30)
Blinded to outcome assessment
No
Does multi-parametric MRI scoring correlate with clinical outcomes in children with acute necrotizing encephalopathy?
Effect estimate: r = 0.1198
Multi-parametric MRI scoring correlates with clinical outcomes in children with acute necrotizing encephalopathy, aiding in early prognostication.
Multi-parametric MRI scoring may aid prognostication in pediatric acute necrotizing encephalopathy; hypothesis-generating and requires prospective validation before clinical adoption.
Background Acute necrotizing encephalopathy of children (ANEC) is a rare fulminant type of acute encephalopathy that mainly occurs in children with a characteristic clinico-radiological pattern. It is commonly preceded by viral infections. The condition carries a poor prognosis with high morbidity and mortality rates. We highlight the relationship between diagnostic multi-parametric magnetic resonance imaging (MRI) findings and correlate them with the clinical outcome of children with ANEC by enrollment of MRI scoring. Results The thalami were involved in all 30 patients, brain stem in 80%, basal ganglia (13.3%), cerebral white matter (WM) in 73%, and cerebellar WM in 33%. Hemorrhage was present in 86.7% patients, edema 80%, and necrosis in 13.3%. We found that the patients having the highest MRI scores were in the poor outcome category; whereas the patients with lower MR score (1 or 2) had better outcomes. Statistically positive correlation (r= 0.1198) was found between the multi-parametric MR score and the outcome category. Conclusion An extended multi-parametric MRI should be performed in ANEC, allowing early detection and scoring of the disease for better prognosis. There is a positive correlation between the clinical outcome and the MR scoring.
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Ibrahim et al. (2020) conducted an observational in Acute necrotizing encephalopathy of children (ANEC) (n=30). Multi-parametric MRI score was evaluated on Correlation between multi-parametric MRI score and clinical outcome category (r = 0.1198). A higher multi-parametric MRI score was associated with poorer clinical outcomes in children with acute necrotizing encephalopathy, demonstrating a positive correlation (r=0.1198) between the score and outcome severity.
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