Myelination of the brain in MRI: a staging system.

In a retrospective study 516 cranial MRI examinations of children aged 1 month to 14 years were re-evaluated for myelination. An objective staging system for the assessment of the degree of myelination was designed, based on the characteristic patterns of myelin-typical signal which develop in the course of brain maturation. Thus myelination can be estimated using only routine MRI examinations; no additional measurements of signal intensities are necessary. In order to obtain detailed information, ten regions of the brain are ranked separately, with comparisons of the T1- and T2-weighted images for each region. The application of the staging system to the case material revealed typical age ranges for the stages, and retarded myelination in some children. In most cases the observed retardation affected several regions but never the whole brain. Such delays can only be detected by separate assessment of the degree of myelination in each region of the brain.