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Apparent diffusion coefficient (ADC) and magnetization transfer ratio (MTR) in pediatric hypoxic-ischemic brain
P Jissendi Tchofo1, C Christophe, P David
1Clinique de Neuroradiologie, Service de Radiologie, Hôpital Erasme, Route de Lennik 808, 1070 Bruxelles. jissendi@netscape.net
Insights
Quantitative MRI using Apparent Diffusion Coefficient (ADC) and Magnetization Transfer Ratio (MTR) can detect diffuse brain lesions in pediatric hypoxic-ischemic injury. This method offers reproducible quantification for better diagnosis and management of these critical conditions.
Area of Science:
- Pediatric neurology
- Neuroradiology
- Quantitative MRI
Background:
- Diffusion magnetic resonance imaging (dMRI) is increasingly used for pediatric hypoxic-ischemic brain injury.
- Apparent Diffusion Coefficient (ADC) and Magnetization Transfer Ratio (MTR) are quantitative MRI tools.
- Combined ADC and MTR analysis has not been explored in young pediatric patients with hypoxic-ischemic injury.
Purpose of the Study:
- To apply a quantitative method using ADC and MTR calculations.
- To propose a reproducible method for quantifying brain parenchymal lesions in pediatric hypoxic-ischemic injury.
Main Methods:
- Prospective study of 15 children (36 weeks gestation to 17 months) with suspected hypoxic-ischemic injury.
- 1.5 Tesla MRI including conventional sequences, diffusion-weighted imaging (DWI) with ADC maps.
- Region of interest (ROI) measurements of ADC and MTR in white matter, gray matter, and focal lesions.
Main Results:
- ADC and MTR values were abnormal in focal and diffuse lesions, including those not visible on conventional MRI or DWI.
- A strong inverse correlation was observed between ADC and MTR values in both white matter (R=0.66) and gray matter (R=0.61).
Conclusions:
- ADC and MTR calculations provide a reproducible method for quantifying brain lesions in pediatric hypoxic-ischemic injury.
- This combined quantitative approach can detect diffuse lesions not apparent on standard MRI sequences.
Background And Purpose:
a review of the literature reveals the increasing interest in using Diffusion magnetic resonance imaging, with diffusion weighted images (DWI) and ADC (Apparent Diffusion Coefficient) quantitation, in pediatric hypoxic-ischemic brain injury. However, ADC and MTR (Magnetization Transfer Ratio) as quantitative tools have not been investigated together in these pathological conditions in young pediatric patients. The aim of this study was to apply a quantitative method by using ADC and MTR calculation in order to propose a reproducible quantitation of brain parenchymal lesions.
Methods:
we conducted a prospective study including all children presenting with suspected cerebral hypoxic-ischemic injury. 15 children were included, among them 10 males and 5 females aged from 36 weeks of gestation to 17 months with a median age of 10,5 months. All MR examinations were performed at 1.5 Tesla unit including conventional MR (T1, T2 and Inversion-recovery sequences) and DWI with ADC map. ADC and MTR ROI (region of interest) measurements were made, in the frontal subcortical and periventricular white matter (WM) as well as in the gray matter (GM=basal ganglia), and in focal lesions.
Results:
ADC and MTR values were abnormal in focal lesions and in diffuse injury with no evidence of lesion on conventional MRI and DWI. We observed a strong inverse correlation between these ADC and MTR (R=0,66 in WM; R=0,61 in GM).
Conclusion:
ADC and MTR calculation may be helpful as a reproductive method to quantify the lesions and detect diffuse lesions in hypoxic-ischemic pediatric brain injury.
