Department of Radiology, Fletcher Allen Health Care, Burlington, VT 05401, USA.
Pediatr Radiol. 2013 Sep;43(9):1196-203. doi: 10.1007/s00247-013-2677-2. Epub 2013 Mar 26.
Despite pharmacological and surgical interventions, some children with periventricular nodular heterotopia (PNH) remain refractory to treatment, which suggests more diffuse pathology potentially involving perilesional white matter.
The purpose of this study was to evaluate MR diffusion tensor imaging (MRDTI) metrics within perilesional white matter in children with PNH.
Six children with PNH (four boys; average age 3.2 years, range 2 months to 6 years) were studied with MRDTI at 3 T. Fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) were quantified within perilesional white matter at distances of 5 mm, 10 mm, 15 mm, and 20 mm from focal areas of PNH and compared to location-matched ROIs in six healthy control patients (two boys, average age 3.3 years, range 2-6 years). Statistical significance was set at an overall level of α = 0.05, corrected for multiple comparisons.
Perilesional white matter showed significantly decreased fractional anisotropy and elevated mean and radial diffusivity at all evaluated distances. No significant differences in axial diffusivity were detected at any distance.
PNH is associated with microstructural white matter abnormalities as indicated by abnormal perilesional MRDTI metrics detectable at least 20 mm from visible nodular lesions.
尽管进行了药物和手术干预，一些脑室周围结节性异位（PNH）患儿仍对治疗无反应，这表明存在潜在的更广泛的病变，可能涉及病变周围的白质。
本研究旨在评估 PNH 患儿病变周围白质的磁共振扩散张量成像（MRDTI）指标。
对 6 名 PNH 患儿（4 名男性；平均年龄 3.2 岁，范围 2 个月至 6 岁）进行了 3T 磁共振弥散张量成像检查。在距 PNH 焦点区域 5mm、10mm、15mm 和 20mm 处测量病变周围白质的各向异性分数（FA）、平均弥散度（MD）、径向弥散度（RD）和轴向弥散度（AD），并与 6 名健康对照患者（2 名男性，平均年龄 3.3 岁，范围 2-6 岁）的匹配 ROI 进行比较。统计显著性设定为总体水平的α=0.05，并进行了多次比较校正。
病变周围白质在所有评估距离均显示出明显的各向异性分数降低和平均弥散度和径向弥散度升高。在任何距离均未检测到轴向弥散度的显著差异。
PNH 与白质微观结构异常有关，病变周围 MRDTI 指标异常可在可见结节性病变至少 20mm 处检测到。
