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Diffusion-Tensor MR Imaging in Children with Developmental Delay: Preliminary Findings¹

Christopher G. Filippi, MD, Doris D. M. Lin, MD, Apostolos J. Tsiouris, MD, Richard Watts, DPhil, A. Maurine Packard, MD, Linda A. Heier, MD and Aziz M. Ulu, PhD

¹ From the Departments of Radiology (C.G.F., A.J.T., R.W., D.D.M.L., L.A.H., A.M.U.) and Pediatrics (A.M.P.), New York Presbyterian Hospital-Weill Medical College of Cornell University, NY; and Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, Md (D.D.M.L.). Received February 6, 2002; revision requested April 9; final revision received January 9, 2003; accepted January 22. Address correspondence to C.G.F., 4 E Short Road South, Grand Isle, VT 05458 (e-mail: sairaallapeikko@yahoo.com).

PURPOSE: To determine whether diffusion-tensor magnetic resonance (MR) imaging can depict abnormalities in patients with a diagnosis of developmental delay but structurally normal brain MR imaging results.

MATERIALS AND METHODS: Twenty pediatric patients who received a diagnosis of developmental delay underwent brain MR examinations, including diffusion-tensor MR imaging. The MR findings in these patients were compared with those in 10 age-matched neurodevelopmentally healthy children. Diffusion constant (D_av) and anisotropy were measured bilaterally in regions of interest in the centrum semiovale, corona radiata, internal capsule, corpus callosum, and subcortical white matter of the frontal and parieto-occipital lobes. By using a one-tailed Student t test in the positive direction for D_av and in the negative direction for anisotropy and P < .05 to indicate a significant difference, the D_av and anisotropy values for children with developmental delay were compared with those for children who were neurodevelopmentally healthy.

RESULTS: The children with developmental delay had significant increases in D_av in all measured structures (P, <.001 to <.03). Significant decreases in anisotropy were detected in all white matter fiber tracts studied (P, <.001 to <.03) except the posterior limb of the internal capsule.

CONCLUSION: In the children with developmental delay, diffusion-tensor MR imaging depicted decreases in anisotropy and increases in D_av in the white matter fiber tracts, which appeared to be normal at conventional MR imaging.

© RSNA, 2003

Index terms: Brain, abnormalities, 13.14, 13.87 • Brain, growth and development • Brain, MR, 13.121411, 13.121413, 13.121416, 13.12144 • Children, central nervous system • Magnetic resonance (MR), diffusion study, 13.12144

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