title: Diffusion tensor imaging detects early brain microstructure changes before and after ventriculoperitoneal shunt in children with high intracranial pressure hydrocephalus.
abstract: To explore the use of diffusion tensor imaging (DTI) parameters in the quantitative assessment of early brain microstructure changes before and after ventriculoperitoneal shunt in children with high intracranial pressure hydrocephalus.Ten patients with communicating hydrocephalus (age: 2-36 months) and 14 age-/gender-matched controls (age: 2-36 months) were enrolled in this study. All patients underwent the ventriculoperitoneal shunt procedure. The imaging data were collected before and 3 months after the operation. Regions of interests (ROIs) included the white matter near the frontal horn of the lateral ventricles (FHLV), the occipital horn of the lateral ventricles (OHLV), occipital subcortical (OS) area, frontal subcortical (FS) area, and thalamus. Fractional anisotropies (FA) and apparent diffusion coefficients (ADC) of the ROIs before and after ventriculoperitoneal shunt were compared between the patients and the controls.Three months after surgery, the patients recovered from the surgery with ameliorated intracranial pressure and slight improvement of clinical intelligence scale and motor scale. Before ventriculoperitoneal shunt, the FA values (except the right FHLV) were significantly decreased and the ADC values were significantly increased in the patients with hydrocephalus, compared with the controls. After the ventriculoperitoneal shunt, the FA values in the FHLV and OHLV of the patients were similar to the controls, but the FA values in other ROIs were still significantly lower than controls. The ADC values in the FS and OS white matter areas of the patients were similar to the controls; however, the ADC values in other ROIs were still significantly higher in patients.The increase of FA and the reduction in ADC in the ROIs preceded the clinical function improvement in patients with high intracranial pressure hydrocephalus and reflected the early changes in brain tissue microstructure, such as the compression of the white matter areas in the ROIs.
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an Department of Radiology, Shenzhen Children's Hospital, Shenzhen The Key Laboratory of Biomedical Information Engineering, Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an Institute of Clinical Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
authors.forename: Cailei
authors.initials: C
authors.lastname: Zhao
authors.forename: Yongxin
authors.initials: Y
authors.lastname: Li
authors.forename: Weiguo
authors.initials: W
authors.lastname: Cao
authors.forename: Kui
authors.initials: K
authors.lastname: Xiang
authors.forename: Heye
authors.initials: H
authors.lastname: Zhang
authors.forename: Jian
authors.initials: J
authors.lastname: Yang
authors.forename: Yungen
authors.initials: Y
authors.lastname: Gan
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging*; D002675:Child, Preschool; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D007223:Infant; D007427:Intracranial Pressure / Q000502:physiology*; D008297:Male; D011184:Postoperative Period; D057234:Preoperative Period; D012189:Retrospective Studies; D013997:Time Factors; D017287:Ventriculoperitoneal Shunt