Abstract
Objective This study aims to examine the rates of incidental findings (IF) and radiologic common data elements (rCDE), and to explore how these magnetic resonance imaging (MRI) findings contribute to a broad assessment of clinical outcomes (symptoms, cognitive and behavioral functioning, and quality of life) in the sub-acute (SA: ∼1 week), early chronic (EC: ∼4 months), and late chronic (LC: ∼1 year) phases of pediatric mild traumatic brain injuries (pmTBI).
Background It is unclear whether MRI findings have clinical implications following injury.
Design/Methods Two hundred thirty-three pmTBI patients and 168 HC aged 8–18 completed an MRI scan and a comprehensive clinical assessment at SA visit, with a subset completing the clinical assessment at EC (182 pmTBI; 158 HC) and LC (143 pmTBI; 141 pmTBI) visits. All MRI findings were noted by board-certified neuroradiologists and coded based on published criteria for rCDE by 2 independent researchers, who were blinded to diagnosis group. A series of 2 × 3 (group [pmTBI vs HC] × MRI findings [IF vs rCDE vs normal]) generalized linear model was conducted for outcomes at each visit. Possible and probable rCDE were pooled for the latter analyses.
Results One hundred sixty-four participants (40.9%) showed positive MRI findings (113 IF, 43 possible rCDE, 8 probable rCDE). As expected, probable rCDE was exclusively observed in pmTBI patients (Fisher's exact one-sided = 0.012), however the incidence of IF and possible rCDE was similar between groups (χ2 = 2.969; p's = 0.085). While group effects were observed on several outcome measures, no interaction of Group × MRI findings survived the correction for multiple comparisons (p's > 0.01). An MRI findings effect (p < 0.001) was observed on child-rated Children's Behavior Questionnaire at SA visit (normal > IF and rCDE; p's = 0.009). However, this effect was no longer significant at EC and LC (p's = 0.439).
Conclusions Overall, the current results do not suggest that MRI findings have clinical implications or interacts with pmTBI to worsen outcomes.
Footnotes
Disclosure: Veronik Sicard has nothing to disclose. Dr. Hergert has nothing to disclose. Dr. Stephenson has nothing to disclose. Ms. Robertson-Benta has received personal compensation for serving as an employee of Mind Research Network. Miss Pabbathi Reddy has received personal compensation for serving as an employee of The Mind Research Network. Mr. Dodd has nothing to disclose. Mr.Ling has nothing to disclose. Mr. Wertz has nothing to disclose. Mr. Pluto has nothing to disclose. Richard Campbell has nothing to disclose. Dr. Phillips has nothing to disclose. The institution of Dr. Sapien has received research support from HRSA. Mr. Oglesbee has nothing to disclose. Mr. Yeates has received personal compensation in the range of $10,000–$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Psychological Association. The institution of Mr. Yeates has received research support from National Institutes of Health. The institution of Mr. Yeates has received research support from Canadian Institutes of Health Research. The institution of Mr. Yeates has received research support from Brain Canada Foundation. The institution of Mr. Yeates has received research support from Alberta Health Services. Dr. Mayer has nothing to disclose.
- © 2021 American Academy of Neurology
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