Assessment of Neurodevelopmental Outcomes in Children With Congenital Heart Disease Using Magnetic Resonance Imaging (MRI): Focus on Brain Volume as a Predictor of Neurodevelopmental Abnormalities.

Abstract

Objective: This study aims to evaluate the neurodevelopmental outcomes in children with congenital heart disease (CHD) using magnetic resonance imaging (MRI), and to assess the role of brain volume metrics as predictors of neurodevelopmental abnormalities.

Methods: In this retrospective cohort study, 160 children with CHD treated at Children's Hospital of Nanjing Medical University from January 2020 to December 2023 were analyzed. Patients were classified into normal (DQ ≥ 70, n=106) and abnormal neurodevelopment (DQ < 70, n=54) groups based on Developmental Quotient (DQ) scores. MRI scans were used to measure total brain volume, cortical gray matter, deep gray matter, white matter, and cerebrospinal fluid volumes. Neurodevelopmental assessments focused on adaptive behavior, motor skills, language, and personal-social behavior. ROC analysis was performed to determine the predictive value of brain volume metrics for neurodevelopmental abnormalities.

Results: Total brain volume in the normal group (341.82 ± 10.43 mL) was significantly higher than in the abnormal group (323.92 ± 10.24 mL) (P < 0.05). Cortical gray matter volume in the normal group (131.47 ± 4.02 mL) was also significantly greater than in the abnormal group (121.63 ± 6.91 mL) (P < 0.05). No significant differences were observed in white matter, deep gray matter, or cerebrospinal fluid volumes. Children in the abnormal group scored significantly lower in all developmental domains (P < 0.05). ROC analysis showed that total brain volume (AUC = 0.968) and cortical gray matter volume (AUC = 0.936) were strong predictors of neurodevelopmental abnormalities (P < 0.001).

Conclusion: Total brain volume and cortical gray matter volume, as measured by MRI, are effective predictors of neurodevelopmental abnormalities in children with CHD and can serve as valuable tools for early neurodevelopmental assessment.