Published: 2022-11-25

Neuroimaging in paediatric patients with developmental delay

Abhinaya G., Gautam M., Gagandeep M. Y., Parthasarathi A.


Background: Aim and objectives of the study were to radiologically evaluate paediatric patients with developmental delay (DD), assess the relative prevalence of abnormal brain MRI, further categorize them based on the abnormal imaging findings and structures affected. The purpose of this study is to diagnose the underlying etiology that helps in early treatment and amelioration of the condition, parental counselling regarding the outcome of the child, providing an estimate of child’s developmental potential and the recurrence risk in siblings.

Methods: 135 paediatric patients of the age 3 months to 15 years with DD referred to department of radiology were investigated with MRI scans of the brain via 1.5T Siemens scanner after making the child sleep or sedated. The sequences used were: axial T1, axial T2, axial FLAIR, axial DWI, axial ADC, axial SWI, axial PHASE, sagittal T1 and coronal FLAIR. CT scan of the brain was done only when indicated on 128 slice Siemens Somatom perspective scanner. Informed consent shall be taken from patient’s parents. Clinical and demographic details of the enrolled patients were noted in the Performa. Data collected was analysed using descriptive and inferential statistics.

Results: Out of 135 children with DD, 69.1% (n=92) were male and 31.9% (n=43) were female. Majority of these children belonged to 3 months to 1 year and 2 to 5 years of age group. About 81.4% (n=110) of children with DD had abnormal findings in MRI. Among children with abnormal MRI findings, 42.9% had hypoxic ischemic changes, 6.6% had congenital malformations and non-specific causes, respectively 4.4% had neurodegenerative and occlusive neurovascular conditions, respectively 3.7% had CSF disorders and neoplasms, respectively 2.9% had infection associated changes and non-traumatic intracranial bleed, respectively 2.2% had metabolic disorders and 0.7% had demyelination. Majority of cases had ventricular abnormality, followed by the corpus callosum.

Conclusions: DD presents with a wide spectrum of etiologies, clinical findings and MRI features ranging from completely normal to abnormal. The present study could establish the various morphological appearances of DD on MRI and further categorize them into various subgroups be effective in diagnosis, management and prognosis determination processes.


DD, Paediatric neuroimaging, MRI brain

Full Text:



Williams HJ. Imaging the child with developmental delay. Imaging. 2004;16(2):174-85.

Aicardi J. The etiology of developmental delay. In: Bodensteiner J, ed. Seminars in Pediatric Neurology. Philadelphia, PA: W.B. Saunders Co. 1998;5:15.

Simeonsson R, Simeonsson N. Developmental Surveillance and Intervention. In: Hoekelman R ed. Primary Pediatric Care. St. Louis: Mosby. 1997;236.

Shevell M, Ashwal S, Donley D. Practice parameter: evaluation of the child with global developmental delay: report of the Quality Standards Subcommittee of the American Academy of Neurology and The Practice Committee of the Child Neurology Society. Neurology. 2003;60:367.

Srour M, Mazer B, Shevell MI. Analysis of clinical features predicting etiologic yield in the assessment of global developmental delay. Pediatrics. 2006;118:139.

Majnemer A, Shevell MI. Diagnostic yield of the neurologic assessment of the developmentally delayed child. J Pediatr. 1995;127:193Y199.

Fenichel G. Clinical Pediatric Neurology: A Signs and Symptoms Approach. 3rd ed. Philadelphia: W.B. Saunders Company; 1997.

Kinsbourne M, Graf W. Disorders of mental development. In: Menkes JHSH, ed. Child Neurology. 6th ed. Philadelphia: Lippincott Williams and Wilkins. 2001;1155.

Accardo P, Capute A. Mental retardation. In: Oski F, DeAngelis C, Feigin R eds. Principles and Practice of Pediatrics. Philadelphia: Lippincott. 1994;673.

Shevell M. The evaluation of the child with a global developmental delay. In: Bodensteiner J, ed. Seminars in Pediatric Neurology. Vol 5. Philadelphia: W.B. Saunders, Co. 1998;21.

Classification of developmental delays. Petersen MC, Kube DA, Palmer FB Semin Pediatr Neurol. 1998;5:2-14.

Rodriguez D P, and Poussaint T Y. Neuroimaging of the Child with Developmental Delay Top Magn Reson Imaging. 2007;18:75-92.

Palve R, Verma P, Chandnani S. MRI evaluation of brain in children with developmental delay. Int J Contemporary Med Res. 2016;3(12):3461-3.

Ali AS, Syed NP, Murthy GS. Magnetic resonance imaging (MRI) evaluation of developmental delay in pediatric patients. J Clin Diagn Res. 2015;9(1):TC21-4.

Jauhari P, Boggula R, Bhave A. Aetiology of intellectual disability in paediatric outpatients in Northern India. Dev Med Child Neurol. 2011;53(2):167-72.

Shevell MI, Majnemer A, Rosenbaum P. Etiologic determination of childhood developmental delay. Brain Dev. 2001;23(4):228-35.

Widjaja E, Nilsson D, Blaser S, Raybaud C. White matter abnormalities in children with idiopathic developmental delay. Acta Radiol. 2008;49(5):589-95

Momen AA, Jelodar G, Dehdashti H. Brain Magnetic Resonance Imaging Findings in Developmentally Delayed Children. Int J Pediatr. 2011;2011:386984.

Pandey A, Phadke SR, Gupta N, Phadke RV. Neuroimaging in mental retardation. Indian J Pediatr. 2004;71(3):203-9.

Koul R, Al-Yahmedy M, Al-Futaisi A. Evaluation children with global developmental delay: a prospective study at sultan qaboos university hospital, Oman. Oman Med J. 2012;27(4):310-3.

Battaglia A, Bianchini E, Carey JC. Diagnostic yield of the comprehensive assessment of developmental delay/mental retardation in an institute of child neuropsychiatry. Am J Med Genet. 1999;82(1):60-6.

Frances P. Glascoe developmental screening and surveillance, in Nelson Text Book of Pediatrics, Behrman RE, Kiegman RM, Jenson HB. Saunders, Philadelphia, Pa, USA, 18th edition, 2007;16:74-81.

Barkovich AJ, Kuzniecky RI, Jackson GD, Guerrini R, Dobyns WB. Classification system for malformations of cortical development: update 2001. Neurology. 2001;57(12):2168-78.

Faerber EN, Poussaint TY. Magnetic resonance of metabolic and degenerative diseases in children. Topics in Magnetic Resonance Imaging. 2002;13(1):3-22.

Bouhadiba Z, Dacher JN, Monroc M, Vanhulle C, Menard JF, Kalifa G. MRI of the brain in the evaluation of children with developmental delay. J Radiol. 2000;81(8):870-73.