Clinical applications of diffusion tensor imaging and tractography in children

Diffusion tensor imaging (DTI) is a relatively new addition to routine MR imaging. DTI exploits the preferential movement of water protons within the brain along the axis of the axons. This anisotropic diffusion provides information about the immature brain prior to myelination, during maturation, and in normal and disease states, information that MRI cannot provide. By virtue of sensitivity to anisotropic movement of protons, DTI allows the core of larger individual white matter tracts to be visualized as discreet anatomic structures. DTI can also provide information about the microarchitecture of white matter in the form of metrics referred to as fractional anisotropy and diffusivity. The information contained within the diffusion tensor data can be used to create 3-D mathematical renderings of white matter or tractography. This article is an introduction to DTI for pediatric radiologists interested in exploring potential applications in children.