Scoring of brain maturation in developmentally handicapped children with high-field MR imaging

A four-stage scoring system for brain maturation was established with MR imaging. First, gyration and myelination were analyzed in 50 anamnestically normal children (32-240 weeks postconceptional age). Subsequently 60 patients (same age range) with birth asphyxia, seizures, or developmental delays were evaluated analogously. T1- and T2-weighted images (500/30 and 3,000/120 [repetition time msec/echo time msec]) were obtained with a 2.35-T magnet in all children. Whereas gyration abnormalities were seen in some patients, all handicapped children presented with delayed myelination. In conclusion, prospective staging of brain development (gyration and myelination) is possible and is best obtained with T2-weighted images