Usefulness of DTI-based three dimensional corticospinal tractography in
children with hemiplegic cerebral palsy

Yeo, Ji Hyun; Son, Su Min; Lee, Eun Sil; Moon, Han Ku

Original Article

Korean Journal of Pediatrics 2009;52(1):99-104.
Published online January 15, 2009.

Usefulness of DTI-based three dimensional corticospinal tractography in children with hemiplegic cerebral palsy

Ji Hyun Yeo¹, Su Min Son², Eun Sil Lee¹, Han Ku Moon¹

¹Department of Pediatrics, College of Medicine, Yeungnam Univeristy, Daegu, Korea
²Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam Univeristy, Daegu, Korea

편마비를 가진 뇌성마비 환아에서 확산 텐서강조영상을 이용한 3차원 피질척수로 영상의 유용성

여지현^¹^, 손수민^²^, 이은실^¹^, 문한구^¹

^¹영남대학교 의과대학 소아과학교실
^²영남대학교 의과대학 재활의학교실

Correspondence:
Han Ku Moon, Email: hkmoon@med.yu.ac.kr

Abstract

Purpose
: Magnetic resonance diffusion tensor imaging-based three-dimensional fiber tractography (DTI-FT) is a new method which demonstrates the orientation and integrity of white matter fibers in vivo. However, clinical application on children with cerebral palsy is still under investigation. We present various abnormal patterns of DTI-FT findings and accordance rate with clinical findings in children with hemiplegic cerebral palsy, to recognize the usefulness of DTI-FT.
Methods
: The thirteen children with hemiplegic cerebral palsy evaluated at Yeungnam University hospital from March, 2003 to August, 2007 were enrolled in this study and underwent magnetic resonance DTI-FT of the corticospinal tracts. Two regions of interest (ROI) were applied and the termination criteria were fractional anisotropy ≥0.3, angle≤70o.
Results
: The patterns and distribution of abnormal DTI-based corticospinal tractographic findings were interruption(10 cases, 76.9%), reduction of fiber volume (8 cases, 61.5%), agenesis of corticospinal tract (3 cases, 23.1%), transcallosal fiber (2 cases, 15.4%) and, aberrant corticospinal tracts (4 cases, 30.8%). Abnormal DTI-based corticospinal tractographic findings were in accordance with the clinical findings of cerebral palsy in 84.6% of the enrolled patients.
Conclusion
: Our results suggest that DTI-FT would be a useful modality in the assessment of the corticospinal tract abnormalities in children with hemiplegic cerebral palsy.

Key Words: Cerebral palsy, Diffusion tensor MR imaging, Fiber tractography, Corticospinal tract