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Normal maturation of the neonatal and infant brain: MR imaging at 1.5 T
A J Barkovich1, B O Kjos, D E Jackson
1Department of Radiology, Letterman Army Medical Center, Presidio of San Francisco, CA 94129-6700.
Insights
This study used magnetic resonance (MR) imaging to map normal brain white matter maturation in infants. Findings reveal an orderly developmental pattern, with T1-weighted images useful early and T2-weighted images later for tracking myelination.
Area of Science:
- Neuroimaging
- Developmental Neuroscience
- Pediatric Radiology
Background:
- Normal white matter maturation is crucial for cognitive development.
- Magnetic resonance (MR) imaging provides detailed insights into brain development.
- Understanding typical maturation patterns aids in identifying deviations.
Purpose of the Study:
- To investigate the pattern of normal white-matter maturation using high-field-strength MR imaging.
- To correlate MR imaging findings with infant age and myelination.
- To establish milestones for normal brain maturation on MR images.
Main Methods:
- Eighty-two neurologically normal infants (4 days to 2 years) underwent 1.5-T MR imaging.
- Spin-echo T1-weighted and T2-weighted sequences were utilized.
- Qualitative assessment of white matter changes in 14 brain areas was performed and correlated with age.
Main Results:
- Brain maturation progresses orderly from brain stem to cerebellum and cerebrum.
- Myelination changes appeared earlier on T1-weighted than T2-weighted images.
- T1-weighted images were optimal for monitoring development in the first 6-8 months; T2-weighted images were more useful after 6 months.
Conclusions:
- MR imaging effectively demonstrates orderly white matter maturation.
- Specific imaging sequences (T1 vs. T2) have differential utility based on infant age.
- Persistent areas of long T2 relaxation near the ventricular trigone are normal findings and not indicative of ischemia.
Abstract:
The pattern of normal white-matter maturation as demonstrated with high-field-strength magnetic resonance (MR) imaging was investigated. Eighty-two neurologically normal infants were examined with a 1.5-T unit with use of spin-echo T1-weighted and T2-weighted pulse sequences. The infants ranged in age from 4 days to 2 years. The images were assessed for qualitative changes of white matter relative to gray matter in 14 anatomic areas of the brain and correlated with the patient's age. The MR images showed that changes of brain maturation occur in an orderly manner, commencing in the brain stem and progressing to the cerebellum and the cerebrum. Changes caused by brain myelination were seen earlier on T1-weighted images than on T2-weighted images, possibly because of T1 shortening by the components of the developing myelin sheaths. The later changes on the T2-weighted images correlated best with the development of myelination as demonstrated with histochemical methods. T1-weighted images were most useful in the monitoring of normal brain development in the first 6-8 months of life; T2-weighted images were more useful after 6 months. The milestones in the MR appearance of normal maturation of the brain are presented. Persistent areas of long T2 relaxation times are seen superior and dorsal to the ventricular trigone in all infants examined and should not be mistaken for ischemic change.