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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
The middle interhemispheric variant of holoprosencephaly: magnetic resonance and diffusion tensor imaging findings
Nail Bulakbasi1, Osman Cancuri1, Murat Kocaoğlu1
1Department of Radiology, Faculty of Medicine, Near East University, Lefkoşa, North Cyprus, Turkey.
Objective:
The middle interhemispheric (MIH) variant of holoprosencephaly (HPE) is the incomplete separation of midline cerebral hemispheres with the absence of callosal body. We aimed to describe the additional knowledge of diffusion tensor imaging (DTI) over conventional MRI in the evaluation of patients with MIH variant of HPE.
Methods:
Conventional MRI and DTI data of five patients were retrospectively evaluated. The parenchymal anomalies as well as changes at white matter tracts were systematically reviewed.
Results:
Except the callosal body and central cingulum fibres, which were missing in all patients, all other major white matter tracts (superior and inferior longitudinal, superior and inferior fronto-occipital, subcallosal and uncinate fasciculi and anterior commissure) had a normal course, thickness and integrity on diffusion tensor images. The genial and splenial callosal fibres were altered and rarefied on tractography. All patients had a central ventricular notch extending into the non-cleaved heterotopic grey matter involving the body of the corpus callosum, which is very typical for the MIH variant of HPE. The remnant traversing white matter fibres above the non-cleaved heterotopic grey matter and incomplete partition of the interhemispheric fissure were also identified. No Probst bundles were detected. A single common ventricle without the septum pellucidum was noted in all patients. One patient had incomplete partition of the thalami, and two patients had abnormally oriented thalami without any prominent interthalamic connection. Vertically oriented hippocampi were detected in four out of five patients. Three patients had relatively flat and vertically oriented Sylvian fissures and in two patients, fissures were abnormally connected over the vertex.
Conclusion:
Additional DTI findings can not only clearly reveal the white matter alterations better than conventional MRI but also provide a better understanding of the aetiological changes that cause the MIH variant of HPE.
Advances In Knowledge:
DTI can provide a better analysis of cerebral white matter connectivity and promotes understanding of the underlying microstructural changes that occur in patients with the MIH variant of HPE.
Insights
Diffusion tensor imaging (DTI) offers superior insights into white matter alterations in middle interhemispheric (MIH) variant of holoprosencephaly (HPE). DTI enhances understanding of microstructural changes and etiological factors in HPE patients.
Area of Science:
- Neuroimaging
- Developmental Neuroscience
- Radiology
Background:
- Middle interhemispheric (MIH) variant of holoprosencephaly (HPE) is characterized by incomplete separation of cerebral hemispheres and absent corpus callosum.
- Conventional MRI has limitations in fully characterizing white matter abnormalities in this condition.
Purpose of the Study:
- To evaluate the added value of diffusion tensor imaging (DTI) over conventional MRI in assessing patients with MIH variant of HPE.
- To elucidate white matter tract alterations and connectivity in MIH HPE.
Main Methods:
- Retrospective analysis of conventional MRI and DTI data from five patients with MIH variant of HPE.
- Systematic review of parenchymal anomalies and white matter tract changes.
Main Results:
- DTI revealed normal courses for most major white matter tracts, with exceptions in callosal fibers and central cingulum.
- Tractography showed altered and rarefied genial and splenial callosal fibers.
- Typical features like a central ventricular notch and heterotopic grey matter were observed, along with remnant white matter fibers.
Conclusions:
- Diffusion tensor imaging provides superior visualization of white matter alterations compared to conventional MRI in MIH HPE.
- DTI enhances the understanding of the microstructural changes and etiological factors contributing to MIH variant of HPE.
