Neuroimaging of white matter abnormalities in pediatric hydrocephalus

摘要: Hydrocephalus (HCP) is a severe pathologic condition in which the ventricular system enlarges response to abnor- mal cerebrospinal fluid production and absorption mechanisms. While accumulating evidence implicates damage various white matter (WM) structures as one of major neurobiological mechanisms underlying poor behavioral outcomes children with HCP, current evaluation such remains limited. Diffusion tensor imaging (DTI) unique magnetic resonance technique that exploits differences diffusion properties water molecules different tissue. Anisotropic prop- erties, measured by DTI, are strongly influenced micro-structural components WM thus can help assess tissue constituents, microstructure cytoarchitecture. Initial clinical studies have shown DTI sen- sitive tool for investigating well extent recovery HCP. A key study has periventricular corona radiata between 12-18 years exhibited increased pre-operative fractional anisotropy (FA) driven slightly axial diffusivity more dramatic decreased radial diffusivity. Post-operatively FA these regions returned normal most patients. In contrast, corpus callosum was found low pre-operatively did not respond diversion surgery. recent reported similar lower higher mean infants. However, abnormalities internal capsule were be heterogeneous. Longitudinal showed measurements post-operatively. experimental studies, both neonatal infantile rats induced These findings correlated astrocyte microglial reactivity reduced myelination. This review also discusses interpretations regarding patterns seen HCP regions. Overall, support growing useful non-invasive diagnosis treatment pediatric hydrocephalus.