Hermoye Laurent, Saint-Martin Christine, Cosnard Guy, Lee Seung-Koo, Kim Jinna, Nassogne Marie-Cecile, Menten Renaud, Clapuyt Philippe, Donohue Pamela K, Hua Kegang, Wakana Setsu, Jiang Hangyi, van Zijl Peter C M, Mori Susumu
Diagnostic Radiology Unit, Saint-Luc University Hospital, Universite Catholique de Louvain, Brussels, Belgium.
Neuroimage. 2006 Jan 15;29(2):493-504. doi: 10.1016/j.neuroimage.2005.08.017. Epub 2005 Sep 27.
Recent advances in diffusion tensor imaging (DTI) have made it possible to reveal white matter anatomy and to detect neurological abnormalities in children. However, the clinical use of this technique is hampered by the lack of a normal standard of reference. The goal of this study was to initiate the establishment of a database of DTI images in children, which can be used as a normal standard of reference for diagnosis of pediatric neurological abnormalities. Seven pediatric volunteers and 23 pediatric patients (age range: 0-54 months) referred for clinical MR examinations, but whose brains were shown to be normal, underwent anatomical and DTI acquisitions on a 1.5 T MR scanner. The white matter maturation, as observed on DTI color maps, was described and illustrated. Changes in diffusion fractional anisotropy (FA), average apparent diffusion constant (ADC(ave)), and T2-weighted (T2W) signal intensity were quantified in 12 locations to characterize the anatomical variability of the maturation process. Almost all prominent white matter tracts could be identified from birth, although their anisotropy was often low. The evolution of FA, shape, and size of the white matter tracts comprised generally three phases: rapid changes during the first 12 months; slow modifications during the second year; and relative stability after 24 months. The time courses of FA, ADC(ave), and T2W signal intensity confirmed our visual observations that maturation of the white matter and the normality of its architecture can be assessed with DTI in young children. The database is available online and is expected to foster the use of this promising technique in the diagnosis of pediatric pathologies.
扩散张量成像（DTI）的最新进展使得揭示儿童白质解剖结构和检测神经学异常成为可能。然而，该技术的临床应用因缺乏正常参考标准而受到阻碍。本研究的目的是启动建立儿童DTI图像数据库，该数据库可作为诊断儿科神经学异常的正常参考标准。七名儿科志愿者和23名因临床磁共振检查而转诊但脑部显示正常的儿科患者（年龄范围：0 - 54个月）在1.5T磁共振扫描仪上进行了解剖和DTI采集。描述并展示了在DTI彩色图上观察到的白质成熟情况。在12个部位对扩散分数各向异性（FA）、平均表观扩散常数（ADC(ave)）和T2加权（T2W）信号强度的变化进行了量化，以表征成熟过程的解剖学变异性。几乎所有主要的白质束在出生时都可以识别出来，尽管它们的各向异性通常较低。白质束的FA、形状和大小的演变通常包括三个阶段：在最初12个月内快速变化；在第二年缓慢变化；24个月后相对稳定。FA、ADC(ave)和T2W信号强度的时间进程证实了我们的视觉观察结果，即幼儿白质的成熟及其结构的正常性可以通过DTI进行评估。该数据库可在线获取，有望促进这项有前景的技术在儿科疾病诊断中的应用。
