Bonfield Christopher M, Foley Lesley M, Kundu Shinjini, Fellows-Mayle Wendy, Hitchens T Kevin, Rohde Gustavo K, Grandhi Ramesh, Mooney Mark P
Department of Neurological Surgery, University of Pittsburgh Medical Center;
Neurosurg Focus. 2015 May;38(5):E3. doi: 10.3171/2015.2.FOCUS14849.
OBJECT Craniosynostosis is a condition in which one or more of the calvarial sutures fuses prematurely. In addition to the cosmetic ramifications attributable to premature suture fusion, aberrations in neurophysiological parameters are seen, which may result in more significant damage. This work examines the microstructural integrity of white matter, using diffusion tensor imaging (DTI) in a homogeneous strain of rabbits with simple, familial coronal suture synostosis before and after surgical correction. METHODS After diagnosis, rabbits were assigned to different groups: wild-type (WT), rabbits with early-onset complete fusion of the coronal suture (BC), and rabbits that had undergone surgical correction with suturectomy (BC-SU) at 10 days of age. Fixed rabbit heads were imaged at 12, 25, or 42 days of life using a 4.7-T, 40-cm bore Avance scanner with a 7.2-cm radiofrequency coil. For DTI, a 3D spin echo sequence was used with a diffusion gradient (b = 2000 sec/mm(2)) applied in 6 directions. RESULTS As age increased from 12 to 42 days, the DTI differences between WT and BC groups became more pronounced (p < 0.05, 1-way ANOVA), especially in the corpus callosum, cingulum, and fimbriae. Suturectomy resulted in rabbits with no significant differences compared with WT animals, as assessed by DTI of white matter tracts. Also, it was possible to predict to which group an animal belonged (WT, BC, and BC-SU) with high accuracy based on imaging data alone using a linear support vector machine classifier. The ability to predict to which group the animal belonged improved as the age of the animal increased (71% accurate at 12 days and 100% accurate at 42 days). CONCLUSIONS Craniosynostosis results in characteristic changes of major white matter tracts, with differences becoming more apparent as the age of the rabbits increases. Early suturectomy (at 10 days of life) appears to mitigate these differences.
颅缝早闭是一种颅骨缝线中的一条或多条过早融合的病症。除了因缝线过早融合导致的外观影响外，还会出现神经生理参数异常，这可能会造成更严重的损害。本研究使用扩散张量成像（DTI），在手术矫正前后，对具有简单家族性冠状缝早闭的同基因品系兔的白质微观结构完整性进行检测。方法：诊断后，将兔分为不同组：野生型（WT）、冠状缝早发完全融合的兔（BC）以及10日龄时接受缝线切除术进行手术矫正的兔（BC-SU）。使用配备7.2厘米射频线圈的4.7-T、40厘米孔径的Avance扫描仪，在兔12、25或42日龄时对固定的兔头进行成像。对于DTI，使用3D自旋回波序列，并在6个方向施加扩散梯度（b = 2000秒/毫米²）。结果：随着年龄从12天增加到42天，WT组和BC组之间的DTI差异变得更加明显（p < 0.05，单因素方差分析），尤其是在胼胝体、扣带和海马伞。通过对白质束的DTI评估，缝线切除术使兔与WT动物相比无显著差异。此外，仅使用线性支持向量机分类器基于成像数据就可以高精度预测动物所属的组（WT、BC和BC-SU）。随着动物年龄的增加，预测动物所属组的能力有所提高（12日龄时准确率为71%，42日龄时准确率为100%）。结论：颅缝早闭导致主要白质束发生特征性变化，随着兔年龄的增加，差异变得更加明显。早期缝线切除术（10日龄时）似乎可以减轻这些差异。
