White matter microstructural abnormalities in children with spina bifida myelomeningocele and hydrocephalus: A diffusion tensor tractography study of the association pathways
White matter microstructural abnormalities in children with spina bifida myelomeningocele and hydrocephalus: A diffusion tensor tractography study of the association pathways
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DOI：
10.1002/jmri.21297
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发表时间：
2008-04-01
影响因子：
4.4
通讯作者：
Fletcher, Jack M.
中科院分区：
文献类型：
--
作者：
Hasan, Khader M.;Eluvathingal, Thomas J.;Fletcher, Jack M.
目的：应用全脑扩散张量成像(DTI)对脊柱裂脊髓脊膜膨出(SBM)和分流性脑积水患儿的主要相关通路的微结构异常进行量化。材料和方法：机构审查委员会批准了这项符合《健康保险携带和责任法案》(HIPAA)的研究，并在研究前获得书面知情同意/同意。69名参与者包括38名患有SBM和分流性脑积水的儿童(平均年龄+/-SD=12.30±2.10岁；22名男孩；10名左撇子)和31名年龄和性别匹配的正常发育儿童(11.56岁+/-2.72岁；15名男孩，4名左撇子)。应用弥散张量成像(DTT)描述和量化双侧四条主要的联合通路(弓状、下纵、额枕下部和钩状束)。结果：SBM组的弥散系数没有表现出对照组中随年龄增长而降低的模式。SBM患者的大部分脑白质通路的横向和轴向弥散系数显著升高。在大多数关联通路中，分数各向异性(FA)显著降低。结论：在SBM患儿的关联通路中，DTT表现出弥散张量特征，表现为发育异常(束不可见/显示差，向下箭头FA，向上箭头弥散系数)，髓鞘形成障碍(向上箭头横向扩散系数)，以及轴突固有特征和轴突外/细胞外间隙(向上箭头轴向扩散系数)异常。在SBM儿童中观察到的扩散指标的差异提示随着年龄的增长，脑白质发育异常和持续性变性。
Purpose: To quantify microstructural abnormalities in the major association pathways of children affected by spina bifida myelomeningocele (SBM) and shunted hydrocephalus using whole-brain diffusion tensor imaging (DTI).Materials and Methods: The institutional review board approved this Health Insurance Portability and Accountability Act (HIPAA)-compliant study and written informed consent/assent were obtained prior to the study. The 69 participants included 38 children with SBM and shunted hydrocephalus (age mean +/- SD = 12.30 +/- 2.10 years; 22 boys; 10 left-handed) and 31 age- and sex-matched normally-developing children (11.56 +/- 2.72 years; 15 boys, four left-handed). Diffusion tensor tractography (DTT) was performed to delineate and quantify bilaterally four major association pathways (arcuate, inferior longitudinal, inferior frontooccipital, and uncinate fasciculi).Results: The group with SBM did not exhibit the pattern of age-related decreases in the diffusivities observed in the controls. The transverse and axial diffusivities were significantly elevated in most of the white matter pathways of the participants with SBM. The fractional anisotropy (FA) was significantly lower in most of the association pathways. Many of the association pathways were not traceable in some participants with SBM compared to the controls at the selected FA thresholds.Conclusion: DTT revealed diffusion tensor characteristics of abnormal development (nonvisualization/poor visualization of tracts, down arrow FA, up arrow diffusivities), impairment in myelination (up arrow transverse diffusivity) as well as abnormalities in intrinsic axonal characteristics and extraaxonal/extracellular space (up arrow axial diffusivity) in the association pathways of the SBM children. The differences in the diffusion metrics observed in the children with SBM are suggestive of abnormal white matter development and persistent degeneration with increased age.