title: The clinical utility of MRI in patients with neurodevelopmental disorders of unknown origin.
abstract: BACKGROUND
  Neuroimaging of the brain in the diagnostic work-up of patients with neurodevelopmental disorders is a matter of continuing debate. Recommendations range from performing brain imaging in all patients with neurodevelopmental disorders to performing an MRI only in those with indication on clinical examinations. Important indications for neuroimaging are head size abnormalities and focal neurological findings.
  
  
  METHODS
  Patients with neurodevelopmental disorders of unknown origin (n = 410), referred to a specialized tertiary diagnostic center for neurodevelopmental disorders were included in a retrospective analysis. A 1-day work-up, including an MRI of the brain was performed. Studied were the: (i) yield of MRI scans of the brain and (ii) associations of specific clinical symptoms/signs with abnormal and diagnostic MRI scans.
  
  
  RESULTS
  (i) In 30.7% of the 410 patients with neurodevelopmental disorders (n = 126), abnormal MRI scans were observed, leading to an etiological diagnosis in 5.4% of the patients (n = 22). (ii) Pyramidal disorders (P = 0.001), epilepsy (P = 0.04) and an abnormal head circumference (P = 0.02) were associated with an abnormal MRI scan. The presence of one of the following neurological symptoms/signs: movement disorders, pyramidal disorders, epilepsy, or an abnormal head circumference was associated with a diagnostic MRI scan (P < 0.001) (diagnostic MRI % in neurological versus no neurological symptoms/signs, 13.0% versus 1.9%).
  
  
  CONCLUSIONS
  Neuroimaging of the brain in a tertiary care center for patients with neurodevelopmental disorders of unknown origin is useful, especially in case of neurological symptoms/signs.
authors.affiliation: Department of Metabolic Diseases, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: H M
authors.initials: HM
authors.lastname: Engbers
authors.forename: R A J
authors.initials: RA
authors.lastname: Nievelstein
authors.forename: R H J M
authors.initials: RH
authors.lastname: Gooskens
authors.forename: H Y
authors.initials: HY
authors.lastname: Kroes
authors.forename: R
authors.initials: R
authors.lastname: van Empelen
authors.forename: O
authors.initials: O
authors.lastname: Braams
authors.forename: D
authors.initials: D
authors.lastname: Wittebol-Post
authors.forename: M M W B
authors.initials: MM
authors.lastname: Hendriks
authors.forename: G
authors.initials: G
authors.lastname: Visser
mesh_terms: D000293:Adolescent; D001921:Brain / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies