Normal myelination of anatomic nerve fiber bundles: MR analysis

In order to establish milestones of brain maturation by MR imaging, we examined the initiation of myelination of fiber bundles and of surrounding white matter.

The subjects included 54 healthy infants ranging in age from 35 to 145 weeks by corrected gestational age. Images were obtained on a 1.5-T MR unit. In 24 sites of 18 fiber bundles in eight cross sections obtained perpendicular to the long axis of the brain stem, we analyzed the initiation of myelination and the age at which fiber bundles become indistinguishable owing to myelination of the surrounding white matter (blurring).

The fiber bundles were classified into two groups on the basis of the presence or absence of blurring. The first group (no blurring) was further divided into group 1A, in which myelination began at 35 weeks or less, and group 1B, in which myelination began at 44 weeks or later. The second group (blurring) was divided into group 2A, in which myelination began at 35 weeks or less and blurring occurred at 43 to 49 weeks; group 2B, in which myelination started at 35 weeks or less and blurring began at 67 to 145 weeks; and group 2C, in which myelination began at 36 weeks or later and blurring occurred at 67 to 145 weeks.

The time of blurring, when myelinated fiber bundles become indistinguishable from surrounding white matter owing to the initiation of myelination, is considered to be a useful parameter of brain maturation in infancy.