Morphometric analysis of MRI images in children who suffered an ischemic stroke under the age of two years – a pilot study

Abstract

Morphometric evaluation of MRI images can provide important information about the exact lesion size and its localization in the brain, can guide therapeutic tactics and predict outcomes. At the same time, there are few relevant studies on morphometry in pediatric cohorts and its relationship to outcome data in the remote period of the disease. The aim of the present study is to establish morphometric characteristics of cerebral infarction in the acute period of the disease in a pediatric cohort of patients within a pilot study for further assessment of neural tissue recovery variants and comparison with cognitive function deficits in the residual period. Materials and Methods. The present work was prepared as part of the Psychological Dictionary Research Award competition and focuses on the first data from the morphometric analysis. An extended version of the clinical cohort including children from this study is presented in the published article “Voxel-based morphometry of brain MRI: first results in pediatric ischemic stroke cohort” (Korotkova et al., 2025). We analyzed brain MRI images obtained in the acute period of ischemic stroke in 21 children with the disease debut at the age of up to two years using software (RadiAnt DICOM Viewer, MRIcron, BrainVISA / Anatomist). Results: Qualitative and quantitative analysis revealed a predominance of left hemispheric (n = 10, 48%) middle cerebral artery pool (n = 19, 90%), subcortical localization (n = 15, 71%) with involvement of the internal capsule (n = 13, 62%). The volume of the infarct focus in the experimental sample varied significantly from 409 to 102192 mm3 (median – 2841 mm3) and occupied on average 2.9% of the total brain volume. The average lesion volume was significantly larger in the perinatal stroke group compared with the pediatric stroke group (10.4% vs 1.2%). Thus, brain regions considered important for future neurocognitive and motor development (internal capsule and thalamus) were involved in the ischemic infarct zone in more than half of cases (62%), which defines the importance of pilot morphometric MRI studies in studying the volume and localization of infarcts in young children.