Central nervous system magnetic resonance imaging abnormalities and neurologic outcomes in pediatric patients with congenital nevi: A 10-year multi-institutional retrospective study - 14/10/22
Abstract |
Background |
High-risk congenital melanocytic nevi (CMN) are associated with abnormalities of the central nervous system (CNS), prompting magnetic resonance imaging (MRI) screening guidelines.
Objective |
Describe MRI brain and spine abnormalities in children with CMN and report trends between nevus features, MRI findings, and neurologic outcomes.
Methods |
Retrospective review of individuals aged ≤18 years with an MRI of the brain and/or spine and at least 1 dermatologist-diagnosed CMN.
Results |
Three hundred fifty-two patients were identified. Forty-six children had CMN that prompted an MRI of the brain and/or spine (50% male, average age at first image, 354.8 days). In these children, 8 (17%) had melanin detected in the CNS, of whom all had >4 CMN. One developed brain melanoma (fatal). In patients without CNS melanin, 4 had concerning imaging. Concerning MRI patients had more neurodevelopmental problems, seizures, neurosurgery, and death than individuals with unremarkable imaging. Three hundred six patients received MRIs for other reasons; none detected melanin. No children with only multiple small CMN (n = 15) had concerning imaging.
Limitations |
Lack of a control group, cohort size, and retrospective methods.
Conclusion |
MRI of the brain and spine is useful for detecting intervenable abnormalities in high-risk children. Healthy infants with few small CMN may not require screening MRI.
Le texte complet de cet article est disponible en PDF.Key words : CMN, congenital melanocytic, congenital nevi, congenital nevus, magnetic resonance imaging, neurocutaneous melanocytosis, neurocutaneous melanosis, neurologic
Abbreviations used : CMN, CNS, MRI, PAS
Plan
Funding sources: HN was supported by the Massachusetts General Hospital Department of Dermatology Loretta J. Cummins fellowship award. |
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IRB approval status: Approved by the Partners Healthcare IRB (protocol no. 2016P001413), Boston Children's Hospital IRB (protocol no. P00016307), and University of Massachusetts Chan Medical School IRB (protocol no. H00022247). |
Vol 87 - N° 5
P. 1060-1068 - novembre 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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