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Published on: April 7, 2015
Analysis of multiple B-value diffusion-weighted imaging in pediatric acute encephalopathy
Yasuhiko Tachibana1, Noriko Aida, Tetsu Niwa
1Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Inage-ku, Chiba, Japan.
Insights
Fraction of high b-pair (FH) imaging shows superior detection of subtle pediatric acute encephalopathy lesions compared to apparent diffusion coefficient (ADC) on MRI. This new value aids early diagnosis and treatment for better outcomes.
Area of Science:
- Medical Imaging
- Pediatric Neurology
- Diffusion MRI
Background:
- Acute encephalopathy in children often leads to severe neurological issues.
- Early diagnosis and treatment are crucial but challenged by imaging limitations.
- Current MRI techniques lack sufficient sensitivity and specificity for subtle changes.
Purpose of the Study:
- To compare a novel metric, fraction of high b-pair (FH), with apparent diffusion coefficient (ADC) for detecting pediatric acute encephalopathy.
- To evaluate the diagnostic performance of FH in identifying subtle cortical and subcortical lesions.
Main Methods:
- Retrospective analysis of diffusion-weighted imaging (DWI) from 15 pediatric acute encephalopathy patients and 16 controls.
- Utilized a two-compartment model to derive FH from multi-b-value DWI.
- Visual assessment and region of interest (ROI) analysis comparing FH and ADC values in cortical and subcortical areas.
Main Results:
- FH maps revealed diffuse elevation in cortical and subcortical areas of patients, appearing more widespread than DWI alone.
- ROI analysis showed significantly elevated mean FH in patients compared to controls (P<0.05).
- FH detected subtle changes in areas with minimal DWI findings, unlike ADC which was inconsistent in milder lesions.
Conclusions:
- Fraction of high b-pair (FH) demonstrates superior detectability of subtle cortical and subcortical lesions in pediatric acute encephalopathy compared to ADC.
- FH holds promise as a valuable imaging biomarker for early and accurate diagnosis.
- Improved detection may lead to timely interventions and better patient outcomes.
Abstract:
Acute encephalopathy is a disease group more commonly seen in children. It is often severe and has neurological sequelae. Imaging is important for early diagnosis and prompt treatment to ameliorate an unfavorable outcome, but insufficient sensitivity/specificity is a problem. To overcome this, a new value (fraction of high b-pair (FH)) that could be processed from clinically acceptable MR diffusion-weighted imaging (DWI) with three different b-values was designed on the basis of a two-compartment model of water diffusion signal attenuation. The purpose of this study is to compare FH with the apparent diffusion coefficient (ADC) regarding the detectability of pediatric acute encephalopathy. We retrospectively compared the clinical DWI of 15 children (1-10 years old, mean 2.34, 8 boys, 7 girls) of acute encephalopathy with another 16 children (1-11 years old, mean 4.89, 9 boys, 7 girls) as control. A comparison was first made visually by mapping FH on the brain images, and then a second comparison was made on the basis of 10 regions of interest (ROIs) set on cortical and subcortical areas of each child. FH map visually revealed diffusely elevated FH in cortical and subcortical areas of the patients with acute encephalopathy; the changes seemed more diffuse in FH compared to DWI. The comparison based on ROI revealed elevated mean FH in the cortical and subcortical areas of the acute encephalopathy patients compared to control with significant difference (P<0.05). Similar findings were observed even in regions where the findings of DWI were slight. The reduction of mean ADC was significant in regions with severe findings in DWI, but it was not constant in the areas with slighter DWI findings. The detectability of slight changes of cortical and subcortical lesions in acute encephalopathy may be superior in FH compared to ADC.
