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

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Abstract
Aim: To develop and evaluate a classification system for magnetic resonance imaging (MRI) findings of children with cerebral palsy (CP) that can be used inCPregisters.Method: The classification system was based on pathogenic patterns occurring in different periods of brain development. TheMRIclassification system (MRICS) consists of five main groups: maldevelopments, predominant white matter injury, predominant grey matter injury, miscellaneous, and normal findings. A detailed manual for the descriptions of these patterns was developed, including test cases (http://scpe.edu.eacd.org/scpe/reference-and-training-manual/rtm.php). A literature review was performed andMRICSwas compared with other classification systems. An exercise was carried out to check applicability and interrater reliability. Professionals working with children withCPor inCPregisters were invited to participate in the exercise and chose to classify either 18MRIs orMRIreports of children withCP.Results: Classification systems in the literature were compatible withMRICSand harmonization possible. Interrater reliability was found to be good overall (k=0.69; 0.54–0.82) among the 41 participants and very good (k=0.81; 0.74–0.92) using the classification based on imaging reports.Interpretation: Surveillance of Cerebral Palsy in Europe (SCPE) proposes theMRICSas a reliable tool. Together with its manual it is simple to apply forCPregisters.
Funding Information
  • European Union Health Programme (DG SANCO EAHC 2008-1307/2013-3211)