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DOI: 10.1148/radiol.2412051345
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Childhood White Matter Disorders: Quantitative MR Imaging and Spectroscopy1

J. Patrick van der Voorn, MD, Petra J. W. Pouwels, PhD, Augustinus A. M. Hart, MSc, Judith Serrarens, MD, Michèl A. A. P. Willemsen, MD, PhD, Hubertus P. H. Kremer, MD, PhD, Frederik Barkhof, MD, PhD and Marjo S. van der Knaap, MD, PhD

1 From the Departments of Child Neurology (J.P.v.d.V., J.S., M.S.v.d.K.), Physics and Medical Technology (P.J.W.P.), and Radiology (F.B.), Vrije Universiteit Medical Center, De Boelelaan 1117, 1007 MB Amsterdam, the Netherlands; Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, the Netherlands (A.A.M.H.); and Departments of Child Neurology (M.A.A.P.W.) and Neurology (H.P.H.K.), University Medical Center Nijmegen, Nijmegen, the Netherlands. Received August 12, 2005; revision requested October 18; revision received November 18; final version accepted January 2, 2006. Supported by the Dutch Organization for Scientific Research (Netherlands Organization for Scientific Research Grant 903-42-097), the Dr W. M. Phelps Foundation for Spastics (grant 00026WO), and the Optimix Foundation for Scientific Research. Address correspondence to J.P.v.d.V. (e-mail: jp.vandervoorn{at}vumc.nl).


Figure 1
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  		Figure 1: Volume of interest localizations for MR spectroscopy (stimulated-echo acquisition mode, 6000/20, 10-msec mixing time, 64 accumulations) are shown on transverse T2-weighted MR images (3000/120, one signal acquired) (first image in A–E), with equivalent transverse ADC (second image in A–E), FA (third image in A–E), and MTR (fourth image in A–E) maps and corresponding spectra (right) in, A, healthy 5-year-old boy, B, 2-year-old boy with hypomyelination, C, 6-year-old boy with demyelination, D, 11-year-old girl with myelin vacuolation, and E, 3-year-old girl with cystic degeneration. In B, MR imaging parameters are close to normal, with the exception of increased tCr and mI and decreased MTR. In C, a decrease in tNAA and increase in Cho and mI are evident. In D and E, high ADC and variable decreases of all MR spectroscopy metabolites are seen. MTR is markedly reduced in C.

 

Figure 2
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  		Figure 2a: Graphs show mean and standard deviation (error bars) for (a) MTR, (b) ADC, and (c) FA in control subjects (Con) and patients with hypomyelination (HM), demyelination (DM), myelin vacuolation (MV), and cystic degeneration (CD). ** = P < .01, *** = P < .001.

 

Figure 2
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  		Figure 2b: Graphs show mean and standard deviation (error bars) for (a) MTR, (b) ADC, and (c) FA in control subjects (Con) and patients with hypomyelination (HM), demyelination (DM), myelin vacuolation (MV), and cystic degeneration (CD). ** = P < .01, *** = P < .001.

 

Figure 2
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  		Figure 2c: Graphs show mean and standard deviation (error bars) for (a) MTR, (b) ADC, and (c) FA in control subjects (Con) and patients with hypomyelination (HM), demyelination (DM), myelin vacuolation (MV), and cystic degeneration (CD). ** = P < .01, *** = P < .001.

 

Figure 3
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  		Figure 3a: Graphs show mean and standard deviation (error bars) for (a) tCr, (b) tNAA, (c) Cho, (d) mI, (e) lactate, (f) glutamate, (g) glutamine, and (h) T2 in control subjects (Con) and patients with hypomyelination (HM), demyelination (DM), myelin vacuolation (MV), and cystic degeneration (CD). * = P < .05, ** = P < .01, *** = P < .001.

 

Figure 3
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  		Figure 3b: Graphs show mean and standard deviation (error bars) for (a) tCr, (b) tNAA, (c) Cho, (d) mI, (e) lactate, (f) glutamate, (g) glutamine, and (h) T2 in control subjects (Con) and patients with hypomyelination (HM), demyelination (DM), myelin vacuolation (MV), and cystic degeneration (CD). * = P < .05, ** = P < .01, *** = P < .001.

 

Figure 3
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  		Figure 3c: Graphs show mean and standard deviation (error bars) for (a) tCr, (b) tNAA, (c) Cho, (d) mI, (e) lactate, (f) glutamate, (g) glutamine, and (h) T2 in control subjects (Con) and patients with hypomyelination (HM), demyelination (DM), myelin vacuolation (MV), and cystic degeneration (CD). * = P < .05, ** = P < .01, *** = P < .001.

 

Figure 3
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  		Figure 3d: Graphs show mean and standard deviation (error bars) for (a) tCr, (b) tNAA, (c) Cho, (d) mI, (e) lactate, (f) glutamate, (g) glutamine, and (h) T2 in control subjects (Con) and patients with hypomyelination (HM), demyelination (DM), myelin vacuolation (MV), and cystic degeneration (CD). * = P < .05, ** = P < .01, *** = P < .001.

 

Figure 3
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  		Figure 3e: Graphs show mean and standard deviation (error bars) for (a) tCr, (b) tNAA, (c) Cho, (d) mI, (e) lactate, (f) glutamate, (g) glutamine, and (h) T2 in control subjects (Con) and patients with hypomyelination (HM), demyelination (DM), myelin vacuolation (MV), and cystic degeneration (CD). * = P < .05, ** = P < .01, *** = P < .001.

 

Figure 3
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  		Figure 3f: Graphs show mean and standard deviation (error bars) for (a) tCr, (b) tNAA, (c) Cho, (d) mI, (e) lactate, (f) glutamate, (g) glutamine, and (h) T2 in control subjects (Con) and patients with hypomyelination (HM), demyelination (DM), myelin vacuolation (MV), and cystic degeneration (CD). * = P < .05, ** = P < .01, *** = P < .001.

 

Figure 3
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  		Figure 3g: Graphs show mean and standard deviation (error bars) for (a) tCr, (b) tNAA, (c) Cho, (d) mI, (e) lactate, (f) glutamate, (g) glutamine, and (h) T2 in control subjects (Con) and patients with hypomyelination (HM), demyelination (DM), myelin vacuolation (MV), and cystic degeneration (CD). * = P < .05, ** = P < .01, *** = P < .001.

 

Figure 3
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  		Figure 3h: Graphs show mean and standard deviation (error bars) for (a) tCr, (b) tNAA, (c) Cho, (d) mI, (e) lactate, (f) glutamate, (g) glutamine, and (h) T2 in control subjects (Con) and patients with hypomyelination (HM), demyelination (DM), myelin vacuolation (MV), and cystic degeneration (CD). * = P < .05, ** = P < .01, *** = P < .001.

 




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