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Central tegmental tract hyperintensity: follow-up outcomes from a single-center study
Ali Dablan1, Yusuf Kerem Limon2, Cemil Oktay3
1Department of Radiology, Basaksehir Cam and Sakura City Hospital, TR-34488, İstanbul, Turkey. alidablan@hotmail.com.
Insights
Symmetrical central tegmental tract hyperintensity (CTTH) is a common finding in young children, often resolving over time. This study investigated its prevalence, causes, and outcomes in pediatric patients.
Area of Science:
- Pediatric Radiology
- Neuroimaging
- Child Neurology
Background:
- Symmetrical central tegmental tract hyperintensity (CTTH) is a radiological finding observed in pediatric brain MRI scans.
- Its clinical significance and etiological factors remain incompletely understood, particularly regarding its transient nature.
Purpose of the Study:
- To evaluate the follow-up outcomes of symmetrical central tegmental tract hyperintensity (CTTH) in pediatric patients.
- To explore potential etiological factors associated with CTTH and its resolution patterns.
Main Methods:
- Retrospective review of 7028 pediatric brain MRI scans (0-18 years) for CTTH.
- Analysis of clinical data and follow-up MRI scans for patients with CTTH.
- Correlation of CTTH findings with patient demographics and diagnoses.
Main Results:
- CTTH was identified in 4.02% (206/5113) of pediatric patients, with a higher prevalence in girls (40.3%).
- Epilepsy was the most common etiology (7.8%) among diagnosed cases, with seizures being the primary MRI indication (40.3%).
- Follow-up MRI scans showed CTTH resolution in 28.6% of patients, with a median age of 51.5 months at disappearance.
Conclusions:
- CTTH is a frequent radiological finding in early childhood, potentially representing a transient maturational process.
- While CTTH may resolve spontaneously, its association with clinical conditions like epilepsy warrants further investigation.
- This study provides insights into the evolution and potential causes of CTTH using a large pediatric cohort.
Purpose:
To evaluate the follow-up outcomes of symmetrical central tegmental tract hyperintensity (CTTH) and discuss possible etiological factors involved.
Methods:
Brain MRI scans of 7028 pediatric patients aged 0 to 18 years obtained between July 2015 and May 2020, were reviewed retrospectively for the presence of CTTH. Clinical data of the patients were retrieved from the hospital information system. Patients with follow-up MRI scans were evaluated separately.
Results:
A total of 5113 patients meeting the study inclusion criteria were identified in whom the prevalence of CTTH was 4.02% (n = 206). Of the patients with CTTH, 40.3% (n = 83) were girls, and the median age was 19 months (range, 1-108). The most common MRI indication was seizures (40.3%, n = 83), and among those with a definitive diagnosis, epilepsy was the most prevalent etiology (7.8%, n = 16). 40.7% (n = 84) of the patients with CTTH had follow-up MRI scans. CTTH disappeared on follow-up in 28.6% (n = 24) of the patients. The median age at CTTH disappearance was 51.5 months, and the mean (± SD) time to CTTH disappearance was 31.50 (± 19.02) months.
Conclusion:
CTTH is a radiological finding commonly seen in early childhood but its clinical relevance has not been fully elucidated. While CTTH may be a transient phenomenon representing the maturation process, it may also be associated with a number of clinical conditions. Using a large patient series and follow-up MRI scans, our study shed light on the possible etiological factors of CTTH and its evolution over time.
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