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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.
Acta Radiologica Open
|September 13, 2017
Summary
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.
