title: Brain imaging in normal kids: a community-based MRI study in Malawian children.
abstract: OBJECTIVE
  To collect normative MRI data for effective clinical and research applications. Such data may also offer insights into common neurological insults.
  
  
  METHODS
  We identified a representative, community-based sample of children aged 9-14 years. Children were screened for neurodevelopmental problems. Demographic data, medical history and environmental exposures were ascertained. Eligible children underwent the Neurologic Examination for Subtle Signs (NESS) and a brain MRI. Descriptive findings and analyses to identify risk factors for MRI abnormalities are detailed.
  
  
  RESULTS
  One hundred and two of 170 households screened had age-appropriate children. Two of 102 children had neurological problems - one each with cerebral palsy and epilepsy. Ninety-six of 100 eligible children were enrolled. Mean age was 11.9 years (SD 1.5), and 43 (45%) were boys. No acute MRI abnormalities were seen. NESS abnormalities were identified in 6 of 96 children (6%). Radiographic evidence of sinusitis in 29 children (30%) was the most common MRI finding. Brain abnormalities were found in 16 (23%): mild diffuse atrophy in 4 (4%), periventricular white matter changes/gliosis in 6 (6%), multifocal punctuate subcortical white matter changes in 2 (2%), vermian atrophy in 1 (1%), empty sella in 3 (3%) and multifocal granulomas with surrounding gliosis in 1 (1%). Having an abnormal MRI was not associated with age, sex, antenatal problems, early malnutrition, febrile seizures, an abnormal neurological examination or housing quality (all P values >0.05). No predictors of radiographic sinusitis were identified.
  
  
  CONCLUSIONS
  Incidental brain MRI abnormalities are common in normal Malawian children. The incidental atrophy and white matter abnormalities seen in this African population have not been reported among incidental findings from US populations, suggesting Malawi-specific exposures may be the cause.
authors: Department of Radiology, Michigan State University, East Lansing, MI, USA.
authors: M J
authors: MJ
authors: Potchen
authors: S D
authors: SD
authors: Kampondeni
authors: M
authors: M
authors: Mallewa
authors: T E
authors: TE
authors: Taylor
authors: G L
authors: GL
authors: Birbeck
mesh_terms: D000293:Adolescent; D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000175:diagnosis*; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008295:Malawi; D008297:Male; D009422:Nervous System Diseases / Q000175:diagnosis*; D059906:Neuroimaging / Q000379:methods*; D011237:Predictive Value of Tests; D012307:Risk Factors; D012852:Sinusitis / Q000175:diagnosis