Pace Erika, MacKinnon Andrew D, deSouza Nandita M
CRUK Imaging Centre, The Institute of Cancer Research, Sutton, UK.
The Royal Marsden Hospital, Department of Radiology, Sutton, UK.
Acta Radiol. 2020 Sep;61(9):1240-1248. doi: 10.1177/0284185119894217. Epub 2019 Dec 22.
Bone marrow composition varies with stage of development.
To assess differences in apparent diffusion coefficient (ADC) derived from clivus bone marrow in healthy children by age, pubertal status, and gender as a benchmark when monitoring local and systemic treatment-induced effects.
Non-oncological pediatric patients (30 pre-pubertal [15 girls, 15 boys] and 30 post-pubertal [15 girls, 15 boys]) with previous normal magnetic resonance imaging (MRI) of the brain including diffusion-weighted magnetic resonance imaging (DW-MRI; 1.5-T Philips Achieva-Ingenia, b-values 0 and 1000s/mm) were studied. A 4-6 mm diameter region of interest (ROI), drawn within the clivus on two or three DW-MRI slices, yielded mean and centile ADC values. Pubertal status was recognized from imaging appearances of the pituitary gland and from fusion of the spheno-occipital synchondrosis. Correlations between ADC and age were assessed (Pearson's coefficient). Mann-Whitney U tests compared ADC by age, pubertal status, and gender.
Age and ADC were significantly negatively correlated (median ADC r=-0.48, mean ADC r=-0.42, =0.0001 and 0.0008, respectively) which held true when divided by gender. Mean and median ADC differed significantly before and after puberty for the whole population (=0.0001 and 0.0001, respectively). There was a left shift of the ADC histogram after puberty with significant differences in centile values. ADC differences before and after puberty remained when divided by gender (girls: =0.04 and 0.009, respectively; boys: =0.005 and 0.0002, respectively).
ADC of clivus bone marrow correlates with age in children. ADC decreases significantly after puberty, likely due to replacement of hypercellular marrow with fat. There are no gender-related differences in clivus bone-marrow ADC before or after puberty.
骨髓成分随发育阶段而变化。
评估健康儿童斜坡骨髓表观扩散系数（ADC）在年龄、青春期状态和性别方面的差异，作为监测局部和全身治疗引起的效应时的基准。
对之前脑部磁共振成像（MRI）正常，包括扩散加权磁共振成像（DW-MRI；1.5-T飞利浦Achieva-Ingenia，b值为0和1000s/mm²）的非肿瘤儿科患者进行研究，其中30名青春期前儿童（15名女孩，15名男孩）和30名青春期后儿童（15名女孩，15名男孩）。在两到三个DW-MRI切片上，在斜坡内绘制直径4-6mm的感兴趣区域（ROI），得出平均ADC值和百分位ADC值。根据垂体的影像学表现和蝶枕软骨结合的融合情况确定青春期状态。评估ADC与年龄之间的相关性（Pearson系数）。采用Mann-Whitney U检验比较不同年龄、青春期状态和性别的ADC。
年龄与ADC显著负相关（中位ADC r=-0.48，平均ADC r=-0.42，P分别为0.0001和0.0008），按性别划分时也是如此。整个人群青春期前后的平均和中位ADC有显著差异（P分别为0.0001和0.0001）。青春期后ADC直方图左移，百分位值有显著差异。按性别划分时，青春期前后的ADC差异仍然存在（女孩：P分别为0.04和0.009；男孩：P分别为0.005和0.0002）。
儿童斜坡骨髓ADC与年龄相关。青春期后ADC显著下降，可能是由于高细胞骨髓被脂肪替代。青春期前后斜坡骨髓ADC不存在性别相关差异。
