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Abnormal anisotropic diffusion properties in pediatric myelomeningocele patients treated with fetal surgery: an initial DTI study

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Abstract

Purpose

To investigate white matter microstructural abnormality based on diffusion tensor imaging (DTI) in pediatric patients with fetal repair for myelomeningocele (MMC).

Methods

This was a retrospective analysis of DTI data from 8 pediatric patients with prenatal MMC repair (age range 1.64–33.70 months; sex 3F/5M) and 8 age-matched controls (age 2.24–31.20 months; sex 5F/2M). All participants were scanned on 1.5T GE Signa MR scanner (GE Healthcare, Milwaukee, WI) with the same sequence specifications. Two DTI measures, including fractional anisotropy (FA) and mean diffusivity (MD), were calculated from the genu of corpus callosum (gCC) and the posterior limb of internal capsule (PLIC). DTI values and fronto-occipital horn ratio (FOHR) were tested for group difference based on two-tailed paired t test.

Results

The ventricle size based on FOHR in patients with prenatal MMC repair was significantly larger than that in the age-matched control group (p < 0.001). Statistically significant group difference in DTI (lower FA and higher MD in patient group) was found in gCC (p = 0.007 and 0.003, respectively). A trend level increase in MD was also found (p = 0.065) in PLIC in patients when compared with the age-matched controls.

Conclusion

Our data showed white matter abnormality based on DTI in pediatric patient with fetal repair for MMC. The sensitivity of DTI in detecting white matter abnormality, as shown in the present study, may help to serve as an imaging biomarker for assessing hydrocephalus and improve and optimize decision making for the treatment of hydrocephalus in this patient population.

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Funding

This study is supported in part by the Robert L. McLaurin, MD, Research Fund in Neurosurgery at Cincinnati Children’s Hospital Medical Center.

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Authors and Affiliations

  1. Division of Pediatric Neurosurgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Francesco T. Mangano & Charles B. Stevenson

  2. University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Francesco T. Mangano, Charles B. Stevenson, Usha Nagaraj & Weihong Yuan

  3. Division of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Usha Nagaraj

  4. Specialty Pediatric Center, Children’s Hospital & Medical Center, Omaha, NE, USA

    Adam Conley

  5. Pediatric Neuroimaging Research Consortium, Division of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 5033, Cincinnati, OH, 45229, USA

    Weihong Yuan

Authors
  1. Francesco T. Mangano
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  2. Charles B. Stevenson
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  3. Usha Nagaraj
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  4. Adam Conley
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  5. Weihong Yuan
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Correspondence to Weihong Yuan.

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Mangano, F.T., Stevenson, C.B., Nagaraj, U. et al. Abnormal anisotropic diffusion properties in pediatric myelomeningocele patients treated with fetal surgery: an initial DTI study. Childs Nerv Syst 36, 827–833 (2020). https://doi.org/10.1007/s00381-019-04339-1

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  • DOI: https://doi.org/10.1007/s00381-019-04339-1

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