背景:高危先天性黑素细胞痣(CMN)与中枢神经系统(CNS)异常有关,提示磁共振成像(MRI)筛查指南。
目的:描述CMN患儿的MRI脑和脊柱异常,并报告痣特征之间的趋势,MRI检查结果,和神经系统的结果。
方法:对年龄≤18岁、脑和/或脊柱MRI和至少1名皮肤科医生诊断的CMN患者进行回顾性回顾。
结果:确定了三百五十二名患者。46名儿童患有CMN,提示大脑和/或脊柱的MRI(50%的男性,第一图像的平均年龄,354.8天)。在这些孩子中,8(17%)在中枢神经系统中检测到黑色素,其中所有的CMN都>4。一个人患上了脑黑色素瘤(致命)。在没有中枢神经系统黑色素的患者中,4有关于成像。关于MRI患者有更多的神经发育问题,癫痫发作,神经外科,和死亡比没有明显成像的人。三百六位患者因其他原因接受了MRI;没有检测到黑色素。只有多个小CMN(n=15)的儿童没有影像学检查。
结论:缺乏对照组,队列大小,和回顾性方法。
结论:大脑和脊柱的MRI可用于检测高危儿童的可干预异常。具有少量小CMN的健康婴儿可能不需要筛查MRI。
High-risk congenital melanocytic nevi (CMN) are associated with abnormalities of the central nervous system (CNS), prompting magnetic resonance imaging (MRI) screening guidelines.
Describe MRI brain and spine abnormalities in children with CMN and report trends between nevus features, MRI findings, and neurologic outcomes.
Retrospective review of individuals aged ≤18 years with an MRI of the brain and/or spine and at least 1 dermatologist-diagnosed CMN.
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.
Lack of a control group, cohort size, and retrospective methods.
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.