DTI in a Pediatric Patient with Hydrocephalus |
- 4 month-old patient.
- Meningococcal meningitis at 5 weeks
- Large dilatation of the lateral ventricles (hydrocephalus)
DTI at 4 months
- Philips 1.5T MR scanner, SENSE head coil. Single-shot spin echo-echo planar sequence (SE-EPI)
was used, with diffusion gradients applied in 32 non-collinear directions and b = 700 s/mm2. Fifty axial slices were
acquired, parallel to the AC–PC line. FOV:220 mm,slice thickness: 2.3 mm, matrix: 96*96, reconstruction matrix: 256 * 256, TR = 7859 ms; TE = 80 ms, SENSE reduction factor = 2.5, acquisition time: 5 minutes.
- DTI analysis with DTIstudio (H Jiang & S. Mori, Johns Hopkins University).
- White matter anatomy assessed on color-coded maps (FH: blue, RL: red, AP: green)
Results
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- White matter architecture is abnormal because of the large dilatation of the lateral ventricles.
- Corpus callosum is almost invisible.
- Cortico-spinal (-bulbar & -pontine) tracts are compressed, especially at the level of the corona radiata
- Optic radiations, inferior longitudinal fasciculus, and other AP association tracts are compressed
- WM lesions difficult to identify on DTI images, because of the low anisotropy at this age
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Outcome
- Surgical treatment: ventriculoperitoneal (VP) shunt
- At 3 years:Developmental & language delay, deafness
- Follow-up DTI has not yet been performed
DTI experiment: Dr. Laurent Hermoye. Neuropediatrics: Pr. M-C Nassogne. Saint-Luc University Hospital, Brussels, Belgium.
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