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Changes in delta ADC reflect intracranial pressure changes in craniosynostosis
Yuko Takahashi1, Masaaki Hori1, Kazuaki Shimoji2
1Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan.
Insights
Apparent diffusion coefficient (ADC) changes in white matter after surgery for craniosynostosis may indicate intracranial pressure (ICP) fluctuations. This non-invasive method shows promise for monitoring ICP in pediatric patients.
Area of Science:
- Pediatric Neurosurgery
- Medical Imaging
- Neurology
Background:
- Craniosynostosis can lead to elevated intracranial pressure (ICP) even without apparent symptoms.
- Early, non-invasive detection of intracranial hypertension is crucial for preventing abnormal brain development in children.
Purpose of the Study:
- To evaluate if the apparent diffusion coefficient (ADC) of white matter during the cardiac cycle (ΔADC) changes post-surgery for ICP relief in craniosynostosis.
- To explore ΔADC as a potential non-invasive biomarker for ICP monitoring.
Main Methods:
- Prospective study of ten craniosynostosis patients and four controls.
- Magnetic resonance imaging (MRI) with electrocardiogram-triggered, single-shot diffusion sequences.
- Regions of interest placed on frontal white matter and basal ganglia before and after surgical intervention.
Main Results:
- All ten patients demonstrated significantly higher ΔADC values post-surgery compared to pre-surgery (Wilcoxon signed-rank test, P = 0.005).
- The observed changes in ΔADC suggest a correlation with ICP alterations.
Conclusions:
- Changes in frontal white matter ΔADC before and after surgery in craniosynostosis patients may reflect ICP variations.
- ΔADC measurements present a potential non-invasive tool for monitoring ICP in pediatric neurosurgery patients.
Background:
In patients with craniosynostosis, intracranial pressure (ICP) has been reported to increase even in the absence of overt symptoms. The early and non-invasive detection of intracranial hypertension is important for reducing the risk of abnormal brain development in pediatric patients.
Purpose:
To assess whether the apparent diffusion coefficient (ADC) of white matter during the cardiac cycle (ΔADC) would change after surgery to relieve ICP in children with craniosynostosis.
Material And Methods:
This prospective study included ten patients diagnosed with craniosynostosis and four normal controls. All ten patients underwent magnetic resonance (MR) examinations before and after surgical treatment. Single-shot diffusion MR imaging (MRI) triggered by an electrocardiogram was performed, with regions of interest (ROIs) placed on frontal white matter and basal ganglia.
Results:
In all ten patients, ΔADC values after surgery were higher than those before surgery. This difference was statistically significant (Wilcoxon signed-rank test, P = 0.005).
Conclusion:
The change in ΔADC in the frontal white matter before and after surgery in patients with craniosynostosis indicates that it might reflect the change in ICP. Measurements of ΔADC could be a promising tool for non-invasive monitoring of ICP.
