Department of Radiology, Cincinnati Children's Hospital Medical center, Cincinnati, Ohio, USA.
AJNR Am J Neuroradiol. 2013 Feb;34(2):439-45. doi: 10.3174/ajnr.A3218. Epub 2012 Aug 16.
White matter structural alterations and the correlation with neuropsychological deficits in children with hydrocephalus have not been well investigated. In this prospective study, the objectives were the following: 1) to apply DTI to detect in vivo white matter alterations based on diffusion properties in children with acute hydrocephalus, 2) to quantify early neuropsychological deficits, and 3) to explore the correlation between potential neuropsychological deficits and abnormalities in functionally related white matter.
A total of 44 children, 24 with hydrocephalus and 20 controls, were enrolled in the study. DTI indices, FA, MD, AD, and RD, were evaluated in the gCC, sCC, PLIC, and ALIC. The ABAS-II was used as a broad screener of development, including conceptual, social, practical, and motor skills. The correlation between the Motor Scale and DTI indices in the PLIC was analyzed.
DTI analyses showed that the gCC and sCC in children with hydrocephalus had lower FA and higher MD, driven by the increased RD with statistical significance (P < .05) or trend-level significance (P = .06). The PLIC and ALIC had significantly higher AD in children with hydrocephalus (P < .05). On the ABAS-II, parent ratings of general adaptive skills, conceptual skills, and motor skills were significantly lower in children with hydrocephalus (all at P < .05). The MD and RD values in the PLIC were found to have trend-level or significant correlation with the Motor Scale (P = .057, .041, respectively).
DTI reveals alterations in the white matter structure in children with hydrocephalus with preliminary findings suggesting correlation with clinical motor deficits.
脑积水患儿的白质结构改变及其与神经认知缺陷的相关性尚未得到充分研究。在这项前瞻性研究中，我们的目的如下：1）应用 DTI 检测急性脑积水患儿的活体白质改变及其基于扩散特性的改变；2）量化早期神经认知缺陷；3）探索潜在神经认知缺陷与功能相关白质异常之间的相关性。
共纳入 44 名儿童，其中 24 名脑积水患儿，20 名对照组。在 gCC、sCC、PLIC 和 ALIC 中评估 DTI 指数，FA、MD、AD 和 RD。采用 ABAS-II 作为发育的广泛筛查工具，包括概念、社交、实践和运动技能。分析了 PLIC 中的运动量表与 DTI 指数之间的相关性。
DTI 分析显示，脑积水患儿的 gCC 和 sCC 具有较低的 FA 和较高的 MD，RD 增加具有统计学意义（P <.05）或趋势水平意义（P =.06）。PLIC 和 ALIC 中 AD 明显高于脑积水患儿（P <.05）。在 ABAS-II 中，家长对儿童一般适应技能、概念技能和运动技能的评定明显低于脑积水患儿（均 P <.05）。PLIC 中的 MD 和 RD 值与运动量表呈趋势水平或显著相关（P =.057，P =.041）。
DTI 揭示了脑积水患儿白质结构的改变，初步研究结果表明与临床运动缺陷相关。
