title: Merosin-deficient congenital muscular dystrophy (CMD): a study of 25 Brazilian patients using MRI.
abstract: BACKGROUND
  Merosin-deficient congenital muscular dystrophy (CMD) is characterized clinically by hypotonia and muscular weakness and, on imaging studies, by white matter (WM) abnormality.
  
  
  OBJECTIVE
  To evaluate MRI findings in Brazilian patients with merosin-deficient CMD.
  
  
  METHODS
  Twenty-five patients were evaluated using MRI. Three patients presented with partial merosin deficiency and 22 with total merosin deficiency. Follow-up examinations were done in 7 cases. T1- and T2-weighted images were performed in all examinations, and fluid-attenuated inversion recovery (FLAIR) was performed in 15. Enhanced images were done in 11 cases. The WM involvement was classified according to location and severity.
  
  
  RESULTS
  From 1991 to 2004, 32 MRI examinations were performed. Severe involvement was found in 23 patients in the frontal and temporal lobes, in 18 patients in the parietal lobes, and in 7 patients in the occipital lobes. The brain stem (n=5), cerebellum (n=6), internal capsules (n=1), and external capsules (n=5) were also affected. One patient had occipital pachygyria, and one had cerebellar vermian hypoplasia. No gadolinium enhancement was noted. Follow-up MRI showed no interval change (n=4), progression (n=1), or improvement of the findings (n=2).
  
  
  CONCLUSIONS
  This series of patients demonstrated that there was no correlation between the extent of WM abnormality on MRI and the clinical status and degree of merosin deficiency (partial or total). Bilateral WM involvement was seen to be more prominent in the parietal, frontal, and temporal regions of the brain. The brain stem and internal and external capsules were less affected. Cerebellar WM involvement is rare. Changes on follow-up imaging studies did not correlate with the clinical status of the patient.
authors.affiliation: Department of Radiology, School of Medicine of the University of São Paulo, Av. Dr. Ovidio Pires Campos S/N, Ressonância Magnética, São Paulo, SP, Brazil 05403000. Claudia.leite@hcnet.usp.br
authors.forename: Claudia C
authors.initials: CC
authors.lastname: Leite
authors.forename: Leandro T
authors.initials: LT
authors.lastname: Lucato
authors.forename: Maria G M
authors.initials: MG
authors.lastname: Martin
authors.forename: Lucio G
authors.initials: LG
authors.lastname: Ferreira
authors.forename: Maria B D
authors.initials: MB
authors.lastname: Resende
authors.forename: Mary S
authors.initials: MS
authors.lastname: Carvalho
authors.forename: Suely K N
authors.initials: SK
authors.lastname: Marie
authors.forename: J Randy
authors.initials: JR
authors.lastname: Jinkins
authors.forename: Umbertina C
authors.initials: UC
authors.lastname: Reed
mesh_terms: D001921:Brain / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007797:Laminin / Q000172:deficiency*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009136:Muscular Dystrophies / Q000151:congenital* / Q000473:pathology*
chemical_list: D007797:Laminin