Assessment of myelination progression in subcortical white matter of children aged 6-48months using T2-weighted imaging

作者：Liu, Congcong; Jin, Chao; Jian, Zhijie; Wang, Miaomiao; Li, Xianjun; Liu, Heng; Sun, Qinli; Zeng, Lingxia; Yang, Jian^*

来源：Neuroradiology, 2018, 60(12): 1343-1351.

DOI：10.1007/s00234-018-2108-z

• Children
• Subcortical white matter
• Myelination
• T2WI
• DTI

PurposeThis study aims to provide a screening scoring method by assessing the age-related change of subcortical white matter (WM) myelination via T2-weighted imaging (T2WI).MethodsThis study retrospectively recruited 109 children aged 6-48months without abnormalities on MRI. Based on Parazzini's study, we developed a modified T2WI-based method to assess subcortical WM myelination (frontal, temporal, parietal, occipital lobes, and insula) by scoring WM's signal changes. Inter- and intra-observer agreements were evaluated by Bland-Altman plot. Age-related changes of myelination score were explored by locally weighted scatterplot smoothing (LOESS), linear regression, and Spearman correlation coefficients (r). Relationships between diffusion tensor imaging (DTI) metrics and total myelination score were investigated to further validate practicability of the scoring method by tract-based spatial statistics (TBSS).ResultsThis method showed good intra-observer (mean difference=0.18, SD=0.95) and inter-observer agreements (mean difference=-0.06, SD=1.01). The LOESS and linear regression results indicated that myelination proceeded in two phases: a period of rapid growth (6-20months; slope=0.561) and one of slower growth (21-48months; slope=0.097). Significant correlations between myelination score and age were observed in whole subcortical WM (r=0.945; P<0.001) and all regional subcortical WM (r(_mean)=0.819, range, 0.664-0.928; P<0.001). TBSS found significant correlations of WM-DTI metrics with myelination score during the range of 6-20months, while no significant correlation was observed in 21-48months.ConclusionThe modified T2WI-based screening scoring method is easily feasible to assess myelination progression of subcortical WM, especially suitable for children aged 6-20months. It may show potential in identifying individual developmental abnormalities by scoring assessment in the future clinical practice.

• 出版日期2018-12
• 单位西安交通大学