Unidentified bright objects on brain MRI in children as a diagnostic criterion for neurofibromatosis type 1.
BACKGROUND
Lesions of the brain denominated as unidentified bright objects (UBOs), which are not included in the diagnostic criteria for neurofibromatosis type 1 (NF1) established by the National Institutes of Health (NIH), have been detected by MRI.


OBJECTIVE
The purpose of this study was to investigate the possibility of including the presence of UBOs as a diagnostic criterion for NF1 in children.


METHODS
The study included 88 children between the ages of 2 and 18 years. The case group consisted of 40 children diagnosed with sporadic or familial NF1 according to the criteria established by the NIH. A control group consisted of 48 individuals referred for routine MRI of the brain for other complaints not related to NF1.


RESULTS
UBOs were identified in 70% of the NF1 patients and in none of the control group. The sensitivity of the presence of UBOs for the diagnosis of NF1 was 70% (CI 53-83%), with a false-negative rate of 30% (CI 27-47%), a specificity of 100% (CI 86-100%) and a false-positive rate of 0% (CI 0-14%).


CONCLUSIONS
Faced with the difficulties in diagnosing NF1 in children and the high frequency and specificity of the presence UBOs identified by MRI in our series, we recommend the inclusion of the presence UBOs as a diagnostic criterion for NF1 in children.
Lopes Ferraz Filho
José Roberto
JR
Imaging Department, Medical School in São José do Rio Preto, Av. Brigadeiro Faria Lima 5544, São Pedro, São José do Rio Preto, São Paulo 15090000, Brazil. jrl.ferraz@terra.com.br
Munis
Marcos Pontes
MP
Soares Souza
Antonio
A
Sanches
Rafael Angelo
RA
Goloni-Bertollo
Eni Maria
EM
Pavarino-Bertelli
Erika Cristina
EC
D000293:Adolescent; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009456:Neurofibromatosis 1 / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D003287:Contrast Media