A diffusion tensor magnetic resonance imaging study of paediatric patients with severe non-traumatic brain injury

作者：Molteni Erika; Rocca Maria A; Strazzer Sandra; Pagani Elisabetta; Colombo Katia; Arrigoni Filippo; Boffa Giacomo; Copetti Massimiliano; Pastore Valentina; Filippi Massimo

来源：Developmental Medicine and Child Neurology, 2017, 59(2): 199-206.

DOI：10.1111/dmcn.13332

<jats:sec><jats:title>Aim</jats:title><jats:p>In this observational study using 3T magnetic resonance imaging (<jats:styled-content style="fixed-case">MRI</jats:styled-content>) and diffusion tensor, we investigated the differential effects of pathology, stage of disease, state of consciousness, and aetiology on the modifications of supra‐ and infra‐tentorial white matter tracts and their correlations with clinical scales in paediatric patients with severe non‐traumatic brain injury.</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>Diffusion tensor magnetic resonance imaging (<jats:styled-content style="fixed-case">DT</jats:styled-content>‐<jats:styled-content style="fixed-case">MRI</jats:styled-content>) was obtained from seven children with unresponsive wakefulness syndrome (<jats:styled-content style="fixed-case">UWS</jats:styled-content>; five males, two females; age at event 5y; standard deviation [<jats:styled-content style="fixed-case">SD</jats:styled-content>] 2y 1mo), six children in a minimally conscious state (<jats:styled-content style="fixed-case">MCS</jats:styled-content>; three males, three females; age at event 5y 10mo; <jats:styled-content style="fixed-case">SD</jats:styled-content> 5y), and 10 healthy children as controls(two males, eight females; age at study 10y 10mo; <jats:styled-content style="fixed-case">SD</jats:styled-content> 2y 10mo). Fractional anisotropy, mean, axial, and radial diffusivities were calculated for the corpus callosum, inferior, middle (<jats:styled-content style="fixed-case">MCP</jats:styled-content>), and superior cerebellar peduncles (<jats:styled-content style="fixed-case">SCP</jats:styled-content>).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p><jats:styled-content style="fixed-case">DT</jats:styled-content>‐<jats:styled-content style="fixed-case">MRI</jats:styled-content> parameters from corpus callosum and <jats:styled-content style="fixed-case">SCP</jats:styled-content> differed between patients and controls. <jats:styled-content style="fixed-case">MCP</jats:styled-content> abnormalities were detected in patients presenting non‐traumatic composite aetiology (<jats:italic>n</jats:italic>=4) versus those suffering from pure anoxia (<jats:italic>n</jats:italic>=9). The supra‐tentorial compartment was more damaged (i.e. decreased fractional anisotropy and increased diffusivities) than the infra‐tentorial one. Correlations were found between <jats:styled-content style="fixed-case">DT</jats:styled-content>‐<jats:styled-content style="fixed-case">MRI</jats:styled-content> abnormalities and Glasgow Outcome Scale scores.</jats:p></jats:sec><jats:sec><jats:title>Interpretation</jats:title><jats:p>In paediatric <jats:styled-content style="fixed-case">UWS</jats:styled-content>/<jats:styled-content style="fixed-case">MCS</jats:styled-content>, the severity of clinical disability correlates with white matter tract abnormalities.</jats:p></jats:sec>

• 出版日期2017-2