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Research ArticlePEDIATRICS

Qualitative Assessment of Brain Anomalies in Adolescents with Mental Retardation

Michael D. Spencer, Rod J. Gibson, T. William J. Moorhead, Peter M. Keston, Peter Hoare, Jonathan J.K. Best, Stephen M. Lawrie and Eve C. Johnstone
American Journal of Neuroradiology November 2005, 26 (10) 2691-2697;
Michael D. Spencer
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Rod J. Gibson
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T. William J. Moorhead
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Peter M. Keston
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Peter Hoare
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Jonathan J.K. Best
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Stephen M. Lawrie
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Eve C. Johnstone
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  • Fig 1.
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    Fig 1.

    Examples of absent (A), moderate (B), and marked (C) thinning of the corpus callosum on midsaggital MR images.

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    Fig 2.

    Examples of absent (A), moderate (B), and marked (C) enlargement of the frontal horns of the lateral ventricles. These images also show absent (A), moderate (B), and marked (C) blunting of the lateral angles of the frontal horns of the lateral ventricles.

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    Fig 3.

    Scatterplot of total abnormality score against IQ for all 120 subjects. There is a significant negative correlation for total abnormality score versus IQ (r = −0.320; P < .001).

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    TABLE 1:

    Structural anomalies assessed on MR imaging and their observed frequencies among subjects and controls

    Observed Frequencies
    Moderate AnomalyMarked Anomaly
    Subjects (n = 80)Controls (n = 40)Subjects (n = 80)Controls (n = 40)
    Lateral ventricle
        Blunting of lateral angles of midpoint of body of lateral ventricles3012131
        Blunting of lateral angles of frontal horns of lateral ventricles3112131
        Enlargement of frontal horns of lateral ventricles371470
        Enlargement of body of lateral ventricles401270
        Enlargement of occipital horns of lateral ventricles2812100
        Asymmetry of lateral ventricle281230
        Abnormal shape of lateral ventricle321060
    Third ventricle
        Widening of anterior portion of third ventricle22630
        Widening throughout third ventricle21630
    Cortex
        Enlargement of cortical sulci26930
        Enlargement of subarachnoid spaces22930
        Enlargement of interhemispheric fissure7110
        Enlargement of subarachnoid cisterns231020
    Temporal lobe
        Abnormal shape of hippocampus1040
        Abnormal gyral pattern of hippocampus4010
        Reduced size of hippocampus2030
        Enlargement of temporal horns121050
    White matter abnormalities
        Corpus callosal dysgenesis0000
        Corpus callosal thinning17260
        Corpus callosal notching17920
        Focal high-intensity white matter lesions4030
        White matter high intensity of myelination delay1000
        White matter volume loss4150
        Virchow-Robin spaces382400
    Other abnormalities
        Cavum septi pellucidi or cavum vergae161030
        Aqueduct stenosis0000
        Arachnoid cysts2010
        Porencephalic cysts0010
        Cerebellar tonsil through occipital foramen*141022
        Pachygyria0000
        Polymicrogyria0000
        Gray matter heterotopia1100
        Schizencephaly0000
        Enlarged cisterna magna20620
        Brain stem anomalies1000
        Skull shape anomalies1000
    • * As a guide for this item, “moderate” represents a displacement of 0–5 mm below the basio-opisthion line, and “marked” represents a displacement >5 mm.

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    TABLE 2:

    Item-by-item intraclass correlation (ICC) values for interobserver and intraobserver agreement

    FeatureInterobserver AgreementIntraobserver Agreement
    Lateral ventricle
        Blunting of lateral angles of midpoint of body of lateral ventricles0.950.90
        Blunting of lateral angles of frontal horns of lateral ventricles0.910.85
        Enlargement of frontal horns of lateral ventricles0.790.62
        Enlargement of body of lateral ventricles0.800.62
        Enlargement of occipital horns of lateral ventricles0.570.82
        Asymmetry of lateral ventricle0.750.91
        Abnormal shape of lateral ventricle0.470.80
    Third ventricle
        Widening of anterior portion of third ventricle0.740.52
        Widening throughout third ventricle0.770.52
    Cortex
        Enlargement of cortical sulci0.580.75
        Enlargement of subarachnoid spaces0.640.83
        Enlargement of interhemispheric fissure0.511
        Enlargement of subarachnoid cisterns0.540.73
    Temporal lobe
        Abnormal shape of hippocampus0.821
        Abnormal gyral pattern of hippocampus0.721
        Reduced size of hippocampus0.651
        Enlargement of temporal horns0.610.90
    White matter abnormalities
        Corpus callosal thinning0.750.90
        Corpus callosal notching0.720.89
        Focal high-intensity white matter lesions0.510.94
        White matter volume loss0.681
        Virchow-Robin spaces0.550.73
    Other abnormalities
        Cavum septi pellucidi or cavum vergae0.70—*
        Arachnoid cysts0.941
        Cerebellar tonsil through occipital foramen0.870.85
        Enlarged cisterna magna0.690.58
    Total abnormality score0.930.97
    • Note.—This table excludes 10 items for which the observed frequency was <2% in 120 scans.

    • *ICC could not be calculated due to 0 variance within one set of observations.

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American Journal of Neuroradiology: 26 (10)
American Journal of Neuroradiology
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Michael D. Spencer, Rod J. Gibson, T. William J. Moorhead, Peter M. Keston, Peter Hoare, Jonathan J.K. Best, Stephen M. Lawrie, Eve C. Johnstone
Qualitative Assessment of Brain Anomalies in Adolescents with Mental Retardation
American Journal of Neuroradiology Nov 2005, 26 (10) 2691-2697;

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Qualitative Assessment of Brain Anomalies in Adolescents with Mental Retardation
Michael D. Spencer, Rod J. Gibson, T. William J. Moorhead, Peter M. Keston, Peter Hoare, Jonathan J.K. Best, Stephen M. Lawrie, Eve C. Johnstone
American Journal of Neuroradiology Nov 2005, 26 (10) 2691-2697;
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