MRI evaluation of central tegmental tract hyperintensity in paediatric patients

Büyükceran E. U., Kaynak Şahap S., Fitoz Ö. S.

ECR 2023, Vienna, Avusturya, 28 Şubat - 05 Mart 2023, ss.1-3

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: Vienna
  • Basıldığı Ülke: Avusturya
  • Sayfa Sayıları: ss.1-3
  • Ankara Üniversitesi Adresli: Evet

Özet

MRI evaluation of central tegmental tract hyperintensity in pediatric patients

Purpose: The clinical significance of central tegmental tract hyperintensity (CTTH) is still unclear. Generally, these lesions are considered pathological, and they may possibly be associated with age-related selective sensitivity of the dorsal brain stem. Our purpose is to reveal the clinical and radiological significance of CTTH on T2WI and to evaluate its relationship with the other MRI sequences as well as their clinical associations.

Materials and Methods: Brain MRI examinations of pediatric patients were evaluated retrospectively. In 104 patients with STTH on T2-weighted images, the equivalents of this finding on DWI, ADC map, and FLAIR sequences were also evaluated. In addition to the radiological findings, the patients' clinical informations were recorded.

As well as descriptive statistics, the Mann–Whitney U test was applied for comparisons of the non-normal data and the Chi-squared test and Fisher exact test were used to analyze categorical variables.

Results: The clinical diagnoses of children with CTTH were epilepsy (24%), metabolic disease (15.4%), CP (14.4%), growth retardation (10.6%), immunodeficiency (7.7%). CTTH was most commonly found in isolation. The median age was 17 months in those with diffusion restriction and 33 months in those without diffusion restriction (P=0.01). “Hyperintensity loss in FLAIR sequence” is at a statistically significant level in patients followed up with CP, epilepsy and metabolic diseases (p=0.020).

Conclusion: The smaller median age of patients with diffusion restriction, the correlation between diffusion restriction and FLAIR, and the relationship between FLAIR and clinical diagnoses suggested that CTTH may be a common finding of two different pathophysiological processes. MRI findings may be useful to differentiate axial diffusivity changes and axonal damage from more chronic involvement and myelin damage. Diffusivity studies with DTI in larger series will increase our knowledge about this phenomenon.