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This is the Classification system for MRI findings in children with cerebral palsy for purpose of reporting in research, documentation by clinicians and in national registry. MRICS has been found to be reliable and simple to use. It is a qualitative system and ordinal scale is applied in the form of subcategories.

MRI classification system (MRICS) for children with cerebral palsy: development, reliability, and recommendations

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This is the Classification system for MRI findings in children with cerebral palsy for purpose of reporting in research, documentation by clinicians and in national registry. MRICS has been found to be reliable and simple to use. It is a qualitative system and ordinal scale is applied in the form of subcategories.

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Synopsis of resource:

Neuroimaging, especially MRI is recommended as part of a workup in a case of cerebral palsy. It has been reported to be abnormal in more than 80% cases and helps in understanding the pathogenesis of this motor disorder in addition to predicting the time of neural damage during the gestational periods. This non experimental cross sectional study was carried out to develop a classification scheme for the MRI findings to develop a common language in reporting and documentation. MRICS is based on the timing of insult and the stage of brain development. It has five groups A, B,C,D & E  correlated with GMFCS levels and some of the groups have subgroups based on the extent of lesion. Inter-rater reliability was found to be good. Age at which MRI was performed was flagged as an important limitation of this system with the recommendation to repeat the MRI if it is reported normal under the age of 2 years.

Key learning outcomes

  • MRI Classification System [MRICS] is useful for uniform documentation and reporting in cerebral palsy
  • MRICS was designed after extensive review of literature and undertaking harmonisation exercise with other MRI classification systems used till date
  • MRICS is essentially a qualitative system, reliable and easy to use by  clinicians and other health professionals in this field 

Authors

Kate Himmelmann, MD, PhD, Child Neurologist, Associate Professor at the Sahlgrenska Academy, University of Gothenburg, and senior consultant at the Regional Rehabilitation Centre, Queen Silvia Children’s Hospital, Gothenburg, Sweden. Leader of the CP Register of western Sweden, and Scientific Activites Group of the Surveillance of Cerebral Palsy in Europe, the research network behind the MRI Classification System.

Veronka Horber, MD is pediatrician and child neurologist at the University Children`s Hospital in Tübingen, Germany in the Department of Pediatric Neurology and Developmental Medicine. Special interest in cerebral palsy and imaging in cerebral palsy. In a EU wide network (Surveillance of Cerebral Palsy in Europe, SCPE) involved in studying the epidemiology of CP. Contribution to the development of the Reference and Training Manual of the SCPE, especially concerning the part on neuroimaging and the development of the classification system for MRI results in CP (MRICS).

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