The following is a summary of “Central nervous system magnetic resonance imaging abnormalities and neurologic outcomes in pediatric patients with congenital nevi: A 10-year multi-institutional retrospective study,” published in the November 2022 issue of Dermatology by Neale, et al.
Magnetic resonance imaging (MRI) screening recommendations were prompted by the association of high-risk congenital melanocytic nevi (CMN) with central nervous system (CNS) disorders. For a study, researchers sought to describe CMN-related MRI abnormalities of the brain and spine in children, and note patterns between nevus characteristics, MRI results, and neurologic outcomes.
It was a retrospective analysis of people ≤18 years with at least one CMN identified by a dermatologist and an MRI of the brain or spine.
The names of 352 patients were recorded. An MRI of the brain and/or spine was performed on 46 kids with CMN (50% male, average age at first imaging, 354.8 days). Eight of these kids (17%) had melanin found in the CNS, and they were all found to have >4 CMN. One person got brain melanoma (fatal). Four patients had imaging that was alarming and had no CNS melanin. Compared to people with normal imaging, MRI patients had a higher rate of neurodevelopmental issues, seizures, neurosurgery, and mortality. None of the 336 patients who underwent MRIs for other purposes had melanin found. No children (n = 15) with only small multiple CMNs showed alarming imaging.
For the purpose of identifying treatable anomalies in high-risk children, an MRI of the brain and spine was helpful. Infants that were healthy and had a few small CMN may not need a screening MRI.