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Diffusion tensor imaging findings in young children with benign external hydrocephalus differ from the normal
1Department of Neurosurgery, Division of Pediatric Neurosurgery, 3333 Burnet Avenue, Cincinnati, OH 44529, USA.
Insights
Diffusion tensor imaging (DTI) revealed altered white matter integrity in children with benign external hydrocephalus (BEH). These diffusion tensor imaging (DTI) changes normalized over time, suggesting DTI can aid in monitoring BEH patients.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- Diffusion Tensor Imaging
Background:
- Benign external hydrocephalus (BEH) is a condition affecting infants.
- Understanding white matter (WM) changes in BEH is crucial for management.
- Diffusion tensor imaging (DTI) offers advanced insights into WM microstructure.
Purpose of the Study:
- To compare white matter (WM) integrity in pediatric patients with benign external hydrocephalus (BEH) against age-matched controls.
- To utilize diffusion tensor imaging (DTI) techniques for quantitative analysis.
- To investigate potential normalization of DTI parameters over time in BEH patients.
Main Methods:
- Retrospective analysis of 17 pediatric patients diagnosed with benign external hydrocephalus (BEH).
- Comparison of fractional anisotropy (FA) and mean diffusivity (MD) values from DTI scans with age-matched controls.
- Mixed model analysis for group differences and longitudinal assessment in a subset of patients.
Main Results:
- Significant differences in FA and MD were observed in specific white matter regions, including the genu and splenium of the corpus callosum (gCC, sCC), and posterior limb of the internal capsule (PLIC).
- BEH patients exhibited increased FA and decreased MD compared to controls in key regions.
- No significant differences were detected in later longitudinal scans, indicating normalization of DTI parameters.
Conclusions:
- Diffusion tensor imaging (DTI) can detect subtle white matter (WM) diffusion changes in pediatric benign external hydrocephalus (BEH).
- Increased FA and decreased MD in specific WM regions are characteristic of BEH.
- DTI parameters demonstrate normalization over time, providing objective markers for monitoring BEH patients.
Purpose:
To compare a pediatric population diagnosed with benign external hydrocephalus (BEH) to normal age-matched controls using diffusion tensor imaging (DTI) techniques.
Methods:
We retrospectively identified 17 BEH patients by specific clinical and neuroimaging criteria. Fractional anisotropy (FA) and mean diffusivity (MD) values obtained from DTI scans were compared to a population of age-matched controls and group differences were examined by mixed model analysis. A longitudinal comparison was completed on a subset that underwent multiple scans (n = 8).
Results:
In the genu of the corpus callosum (gCC), six of 15 BEH children had an FA value above the upper limit of 95% prediction interval, nine of 15 BEH children had MD values below the lower limit of 95% prediction interval. A similar trend applied to the other regions of interest (ROIs): splenium of the corpus callosum (sCC), ALIC, and PLIC. Statistical analysis demonstrated significant differences in FA within the gCC, sCC, and PLIC and in MD within the sCC between BEH patients and controls given (P = 0.05). No statistical differences were identified at any ROIs at the later scans.
Conclusions:
We found a significant increase in FA and decrease in MD in children with BEH compared with normal children in specific white matter (WM) ROIs, notably in the gCC and sCC; furthermore, in longitudinal comparison, DTI parameters normalized over time. The current study further demonstrates the ability of DTI to distinguish between subtle diffusion changes in periventricular white matter and establishes preliminary objective radiographic parameters for watchful observation of patients with BEH.
