title: Diffusion tensor imaging of neurofibromatosis bright objects in children with neurofibromatosis type 1.
abstract: Neurofibromatosis bright objects (NBOs) are poorly understood. This article aimed to investigate: 1) differences in fractional anisotropy (FA) between NBOs based in gray matter (GM) and white matter (WM), and 2) the relationship between NBOs and the affected white matter tracts. Fourteen NF1 patients were included in this study. Apparent diffusion coefficient (ADC), FA, radial diffusivity (RD) and eigenvalues were used to compare NBOs and matching contralateral normal-appearing sites (NAS). Diffusion tensor imaging scalars were also compared with age-matched healthy controls. Fiber tractography was performed to assess NBO-induced changes in WM trajectories. ADC values were higher for GM and WM NBOs than for NAS and controls. FA values were lower in GM and WM NBOs compared with controls. In all regions, eigenvalues were higher in NBOs than in NAS and controls. Only three out of 18 NOBs appeared to disrupt WM tracts. ADC, λ2 and RD values of WM NBOs were higher in symptomatic compared to asymptomatic patients. Increased ADC, RD and eigenvalues and decreased FA values in NBOs can be explained by myelin and axonal damage. Increased ADC values and RD in WM NBOs correlated with the presence of symptoms. Tract integrity predominated in our study.
authors.affiliation: Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine; Baltimore, MD, USA - thuisma1@jhmi.edu.
authors.forename: Gulhan
authors.initials: G
authors.lastname: Ertan
authors.affiliation: Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine; Baltimore, MD, USA.
authors.forename: Elcin
authors.initials: E
authors.lastname: Zan
authors.affiliation: Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine; Baltimore, MD, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Yousem
authors.affiliation: The Center for Imaging Science, The Johns Hopkins University; Baltimore, MD, USA.
authors.forename: Can
authors.initials: C
authors.lastname: Ceritoglu
authors.affiliation: Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine; Baltimore, MD, USA.
authors.forename: Aylin
authors.initials: A
authors.lastname: Tekes
authors.affiliation: Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine; Baltimore, MD, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Poretti
authors.affiliation: Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine; Baltimore, MD, USA.
authors.forename: Thierry A G M
authors.initials: TA
authors.lastname: Huisman
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D056324:Diffusion Tensor Imaging; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D009456:Neurofibromatosis 1 / Q000000981:diagnostic imaging*
keywords: children; diffusion tensor imaging; fiber tractography; neurofibromatosis bright objects; neurofibromatosis type 1