Skip to main content

Pattern recognition in magnetic resonance imaging of white matter disorders inchildren and young adults

Summary

Magnetic resonance imaging (MRI) is considered to be a highly sensitive modality for visualizing white matter abnormalities. Estimations of its specificity are far less positive. However, diagnostic specificity depends upon both the inherent qualities of MRI and on the quality of image interpretation. Systematic and detailed analysis of many image elements, and substantial prior experience improve the quality of image interpretation and thus improve diagnostic specificity. The present study has been set up to develop a pattern recognition system which combines sensitivity and specificity, systematic analysis of image elements and prior experience. This pattern recognition is based on the data of 277 patients with white matter disorders referred for MRI. The information was stored in a data base and computer analyzed. Twenty-two MRI patterns were discerned in as many disease categories. The frequency of occurrence of each MRI abnormality was assessed per disease category to establish the pattern of abnormalities characteristic for each separate disease category. The pattern recognition program was also written so that: (a) when fed data about MRI abnormalities observed in a new case, the computer produces a differential diagnosis with probabilities and 95% confidence intervals for each differential diagnosis; (b) specific data on the MRI findings of new cases could be added to the data base to improve the experience and accuracy of the program. This program for pattern recognition of abnormalities in the MR images of white matter disorders enhances the specificity of image interpretation and provides a wonderful aid for teaching purposes.

This is a preview of subscription content, access via your institution.

References

  1. Révész T, Hawkins CP, du Boulay EPGH, Barnard RO, McDonald WI (1989) Pathological findings correlated with magnetic resonance imaging in subcortical arteriosclerotic encephalopathy (Binswanger's disease). J Neurol Neurosurg Psychiatry 52: 1337–1344

    Google Scholar 

  2. Ford CC, Ceckler TL, Karp J, Herndon RM (1990) Magnetic resonance imaging of experimental demyelinating lesions. Magn Reson Med 14: 461–481

    Google Scholar 

  3. Miller DH, Robb SA, Ormerod IEC, Pohl KRE, MacManus DG, Kendall BE, Moseley IF, McDonald WI (1990) Magnetic resonance imaging of inflammatory and demyelinating white-matter diseases of childhood. Dev Med Child Neurol 32: 97–107

    Google Scholar 

  4. McAdams HP, Geyer CA, Done SL, Deigh D, Mitchell M, Ghaed VN (1990) CT and MR imaging of Canavan disease. AJNR 11: 397–399

    Google Scholar 

  5. Getty DJ, Pickett RM, D'Orsi CJ, Swets JA (1988) Enhanced interpretation of diagnostic images. Invest Radiol 23: 240–252

    Google Scholar 

  6. Valk J, van der Knaap MS (1989) Pattern recognition in magnetic resonance imaging of myelin disorders. In: Valk J, van der Knaap MS (eds) Magnetic resonance of myelin, myelination, and myelin disorders. Springer, Berlin Heidelberg New York, pp 327–343

    Google Scholar 

  7. Kertesz A, Black SE, Tokar G, Benke T, Carr T, Nicholson L (1988) Periventricular and subcortical hyperintensities on magnetic resonance imaging. ”Rims, caps, and unidentified bright objects”. Arch Neurol 45: 404–408

    Google Scholar 

  8. Drayer BP (1988) Imaging of the aging brain. I. Normal findings. Radiology 166: 785–796

    Google Scholar 

  9. Valk J, van der Knaap MS (1989) Classification of myelin disorders. In: Valk J, van der Knaap MS (eds) Magnetic resonance of myelin, myelination, and myelin disorders. Springer, Berlin Heidelberg New York, pp 4–8

    Google Scholar 

  10. Sackett DL, Haynes RB, Tugwell P (1985) Clinical epidemiology: a basic science for clinical medicine. Little, Brown, Boston

    Google Scholar 

  11. Davis PC, Hoffman JC, Braun IF, Ahmann P, Krawiecki N (1987) MR of Leigh's disease (subacute necrotizing encephalomyelopathy). AJNR 8: 71–75

    Google Scholar 

  12. Allard JC, Tilak S, Carter AP (1988) CT and MR of MELAS syndrome. AJNR 9: 1234–1238

    Google Scholar 

  13. Koch TK, Yee MHC, Hutchinson HT, Berg BO (1986) Magnetic resonance imaging in subacute necrotizing encephalomyelopathy (Leigh's disease). Ann Neurol 19: 605–607

    Google Scholar 

  14. Von Henkes H, Sperner J, Stoltenburg-Didinger G (1987) Kernspintomographischer Aspekt der Enzephalomyopathie. Fortschr Röntgenstr 147: 214–216

    Google Scholar 

  15. Van der Knaap MS, Valk J (1991) The MR spectrum of peroxisomal disorders. Neuroradiology (in press)

  16. Van der Knaap MS, Valk J (1989) MR of adrenoleukodystrophy: histopathologic correlations. AJNR 10: S12-S14

    Google Scholar 

  17. Ieshima A, Eda I, Matsui A, Yoshino K, Takashima S, Takeshita K (1983) Computed tomography in Krabbe's disease: comparison with neuropathology. Neuroradiology 5: 323–327

    Google Scholar 

  18. Schipper HI, Seidel D (1984) Computed tomography in lateonset metachromatic leukodystrophy. Neuroradiology 26: 39–44

    Google Scholar 

  19. Kumar AJ, Rosenbaum AE, Naidu S, Wener L, Citrin CM, Lindenberg R, Kim WS, Zinreich SJ, Molliver ME, Mayberg HS, Moser HW (1987) Adrenoleukodystrophy: correlating MR imaging with CT. Radiology 165: 497–504

    Google Scholar 

  20. Snoek JW (1989) Reasoning in neurology. A thesis. Dijkhuizen van Zanten, Groningen

    Google Scholar 

  21. Bewermeyer H, Bamborschke S, Ebhardt G, Hünermann B, Heiss WD (1985) MR imaging in adrenoleukomyeloneuropathy. J Comput Assist Tomogr 9: 793–796

    Google Scholar 

  22. Poll-The BT, Roels F, Ogier H, Scotto J, Vamecq, J, Schutgens RBH, Wanders RJA, van Roermund CWT, van Wijland MJA, Schram AW, Tager JM, Saudubray JM (1988) A new peroxisomal disorder with enlarged peroxisomes and a specific deficiency of acyl-CoA oxidase (pseudoneonatal adrenoleukodyotrophy). Am J Hum Genet 42: 422–434

    Google Scholar 

  23. Gilbert EF, Opitz JM, Spranger JW, Langer LO, Wolfson JJ, Viseskul C (1976) Chondrodysplasia punctata rhizomelic form. Pathologic and radiologic studies of three infants. Eur J Pediatr 123: 89–109

    Google Scholar 

  24. Boltshauser E, Yalcinkaya C, Wichmann W, Reutter F, Prader A, Valavanis A (1989) MRI in Cockayne syndrome type I. Neuroradiology 31: 276–277

    Google Scholar 

  25. Nishio H, Kodama S, Matsuo T, Ichihashi M, Ito H, Fujiwara Y (1988) Cockayne syndrome: magnetic resonance images of the brain in a severe form with early onset. J Inherited Metab Dis 11: 88–102

    Google Scholar 

  26. Wardinsky TD, Weinberger E, Pagon RA, Clarren SK, Thuline HC (1990) Partial deletion of the long arm of chromosome 11 with abnormal white matter. Am J Med Genet 35: 60–63

    Google Scholar 

  27. Wisniewski KE, Schmidt-Sidor B (1989) Postnatal delay of myelin formation in brains from Down syndrome infants and children. Clin Neuropathol 8: 55–62

    Google Scholar 

  28. Brown LW, Rorke BL, Deray MJ, Smith SB, Altman N (1985–86) Psychomotor retardation and macrocephaly in an infant. Pediatr Neurosci 12: 266–271

    Google Scholar 

  29. Press GA, Barshop BA, Hass RH, Nyhan WL, Glass RF, Hesselink JR (1989) Abnormalities of the brain in nonketotic hyperglycinemia: MR manifestations. AJNR 10: 315–321

    Google Scholar 

  30. Uziel G, Savoiardo M, Nardocci N (1988) CT and MRI in maple syrup urine disease. Neurology 38: 486–488

    Google Scholar 

  31. Shaw DWW, Weinberger E, Maravilla KR (1990) Cranial MR in phenylketonuria. J Comput Assist Tomogr 14: 458–460

    Google Scholar 

  32. Van der Knaap MS, Valk J (1989) The reflection of histology in MR imaging of Pelizaeus-Merzbacher disease. AJNR 10: 99–103

    Google Scholar 

  33. Silverstein AM, Hirsh DK, Trobe JD, Gebarski SS (1990) MR imaging of the brain in five members of a family with Pelizaeus-Merzbacher disease. AJNR 11: 495–499

    Google Scholar 

  34. Echenne B, Arthuis M, Billard C, Campos-Castello J, Castel Y, Dulac O, Fontan D, Gauthier A, Kulakowski S, De Meuron G, Moore JR, Nieto-Barrera M, Pages M, Parain D, Pavone L, Ponsot G (1986) Congenital muscular dystrophy and cerebral CT scan anomalies. J Neurol Sci 75: 7–22

    Google Scholar 

  35. Yoshioka M, Kuroki S, Mizue H (1987) Congenital muscular dystrophy of non-Fukuyama type with characteristic CT images. Brain Dev 9: 316–318

    Google Scholar 

  36. Ormerod IEC, Miller DH, McDonald WI, du Boulay EPGH, Rudge P, Kendall BE, Moseley IF, Johnson G, Tofts PS, Halliday AM, Bronstein AM, Scaravilli F, Harding AE, Barnes D, Zilkha KJ (1987) The role of NMR imaging in the assessment of multiple sclerosis and isolated neurological lesions. A quantitative study. Brain 1987; 110: 1579–1616

    Google Scholar 

  37. Koopmans RA, Li DKB, Oger JJF, Mayo J, Paty DW (1989) The lesion of multiple sclerosis: imaging of acute and chronic stages. Neurology 39: 959–963

    Google Scholar 

  38. Kesselring J, Miller DH, Robb SA, Kendall BE, Moseley IF, Kingsley D, du Boulay EPGH, McDonald WI (1990) Acute disseminated encephalomyelitis. MRI findings and the distinction from multiple sclerosis. Brain 113: 291–302

    Google Scholar 

  39. Barth PG, Derix MMA, de Krom MCTFM, Valk J, Theumissen PMVM (1989) Schilder's diffuse sclerosis: case study with three year's follow-up and neuro-imaging. Neuropediatrics 20:230–233

    Google Scholar 

  40. Chrysikopoulos HS, Press GA, Grafe MR, Hesselink JR, Wiley CA (1990) Encephalitis caused by human immunodeficiency virus: CT and MR imaging manifestations with clinical and pathologic correlation. Radiology 175: 185–191

    Google Scholar 

  41. Jarvik JG, Hesselink JR, Kennedy C, Teschke R, Wiley C, Spector S, Richman D, McCutchan JA (1988) Acquired immunodeficiency syndrome. Magnetic resonance patterns of brain involvement with pathologic correlation. Arch Neurol 45: 731–736

    Google Scholar 

  42. Davidson HD, Steiner RE (1985) Magnetic resonance imaging in infections of the central nervous system. AJNR 6: 499–504

    Google Scholar 

  43. Mark AS, Atlas SW (1989) Progressive multifocal leukoencephalopathy in patients with AIDS: appearance on MR images. Radiology 173: 517–520

    Google Scholar 

  44. Miller GM, Baker HL, Okazaki H, Whisnant JP (1988) Central pontine myelinolysis and its imitators: MR findings. Radiology 68: 795–802

    Google Scholar 

  45. Brunner JE, Redmond JM, Haggar AM, Kruger DF, Elias SB (1990) Central pontine myelinolysis and pontine lesions after rapid correction of hyponatremia: a prospective magnetic resonance imaging study. Ann Neurol 27: 61–66

    Google Scholar 

  46. Valk J (1990) The concept of topistic areas in MR of toxic encephalopathies (abstract). In: Book of abstracts: Society of Magnetic Resonance in Medicine, vol 2. Society of Magnetic Resonance in Medicine, Berkeley, p 663

    Google Scholar 

  47. Wolters EC, van Wijngaarden GK, Stam FC, Rengelink H, Lousberg RJ, Schipper MEI, Verbeeten B (1982) Leucoencephalopathy after inhaling heroin pyrolysate. Lancet II: 1233–1237

    Google Scholar 

  48. Flodmark O, Lupton B, Li D, Stimac GK, Roland EH, Hill A, Whitfield MF, Norman MG (1989) MR imaging of periventricular leukomalacia in childhood. AJNR 10: 111–118

    Google Scholar 

  49. De Reuck JK, van der Eecken HM (1978) Periventricular leucomalacia in adults. Clinicopathological study of four cases. Arch Neurol 35: 517–521

    Google Scholar 

  50. Plum F, Posner JB, Hain RF (1962) Delayed neurological deterioration after anoxia. Arch Intern Med 110: 18–55

    Google Scholar 

  51. Gerard G, Weisberg LA (1986) Magnetic resonance imaging in adult white matter disorders and hydrocephalus. Semin Neurol 6: 17–23

    Google Scholar 

  52. Curnes JT, Laster DW, Ball MR, Moody DM, Witcofski RL (1986) Magnetic resonance imaging of radiation injury to the brain. AJNR 7: 389–394

    Google Scholar 

  53. Dooms GC, Hecht S, Brant-Zawadzki M, Berthiaume Y, Norman D, Newton TH (1986) Brain radiation lesions: MR imaging. Radiology 158: 149–155

    Google Scholar 

  54. Hayek J, Valavanis A (1982) Computed tomography of gliomatosis cerebri. Comput Radiol 6: 93–98

    Google Scholar 

  55. Spagnoli MV, Grossman RI, Packer RJ, Hackney DB, Goldberg HI, Zimmerman RA, Bilaniuk LT (1987) Magnetic resonance imaging determination of gliomatosis cerebri. Neuroradiology 29: 15–18

    Google Scholar 

Download references

Author information

Affiliations

Authors

Rights and permissions

Reprints and Permissions

About this article

Cite this article

van der Knaap, M.S., Valk, J., de Neeling, N. et al. Pattern recognition in magnetic resonance imaging of white matter disorders inchildren and young adults. Neuroradiology 33, 478–493 (1991). https://doi.org/10.1007/BF00588038

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00588038

Key words

  • Expert system
  • Pattern recognition
  • White matter disorders
  • Magnetic resonance imaging