Congcong Liu1, Chao Jin1, Zhijie Jian1, Miaomiao Wang1, Xianjun Li1, Heng Liu1, Qinli Sun1, Lingxia Zeng2, Jian Yang3,4. 1. Department of Diagnostic Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, People's Republic of China. 2. Department of Epidemiology and Health Statistics School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710054, People's Republic of China. 3. Department of Diagnostic Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, People's Republic of China. yj1118@mail.xjtu.edu.cn. 4. Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710054, People's Republic of China. yj1118@mail.xjtu.edu.cn.
Abstract
PURPOSE: This study aims to provide a screening scoring method by assessing the age-related change of subcortical white matter (WM) myelination via T2-weighted imaging (T2WI). METHODS: This study retrospectively recruited 109 children aged 6-48 months without abnormalities on MRI. Based on Parazzini's study, we developed a modified T2WI-based method to assess subcortical WM myelination (frontal, temporal, parietal, occipital lobes, and insula) by scoring WM's signal changes. Inter- and intra-observer agreements were evaluated by Bland-Altman plot. Age-related changes of myelination score were explored by locally weighted scatterplot smoothing (LOESS), linear regression, and Spearman correlation coefficients (r). Relationships between diffusion tensor imaging (DTI) metrics and total myelination score were investigated to further validate practicability of the scoring method by tract-based spatial statistics (TBSS). RESULTS: This method showed good intra-observer (mean difference = 0.18, SD = 0.95) and inter-observer agreements (mean difference = - 0.06, SD = 1.01). The LOESS and linear regression results indicated that myelination proceeded in two phases: a period of rapid growth (6-20 months; slope = 0.561) and one of slower growth (21-48 months; slope = 0.097). Significant correlations between myelination score and age were observed in whole subcortical WM (r = 0.945; P < 0.001) and all regional subcortical WM (r_mean = 0.819, range, 0.664-0.928; P < 0.001). TBSS found significant correlations of WM-DTI metrics with myelination score during the range of 6-20 months, while no significant correlation was observed in 21-48 months. CONCLUSION: The modified T2WI-based screening scoring method is easily feasible to assess myelination progression of subcortical WM, especially suitable for children aged 6-20 months. It may show potential in identifying individual developmental abnormalities by scoring assessment in the future clinical practice.
PURPOSE: This study aims to provide a screening scoring method by assessing the age-related change of subcortical white matter (WM) myelination via T2-weighted imaging (T2WI). METHODS: This study retrospectively recruited 109 children aged 6-48 months without abnormalities on MRI. Based on Parazzini's study, we developed a modified T2WI-based method to assess subcortical WM myelination (frontal, temporal, parietal, occipital lobes, and insula) by scoring WM's signal changes. Inter- and intra-observer agreements were evaluated by Bland-Altman plot. Age-related changes of myelination score were explored by locally weighted scatterplot smoothing (LOESS), linear regression, and Spearman correlation coefficients (r). Relationships between diffusion tensor imaging (DTI) metrics and total myelination score were investigated to further validate practicability of the scoring method by tract-based spatial statistics (TBSS). RESULTS: This method showed good intra-observer (mean difference = 0.18, SD = 0.95) and inter-observer agreements (mean difference = - 0.06, SD = 1.01). The LOESS and linear regression results indicated that myelination proceeded in two phases: a period of rapid growth (6-20 months; slope = 0.561) and one of slower growth (21-48 months; slope = 0.097). Significant correlations between myelination score and age were observed in whole subcortical WM (r = 0.945; P < 0.001) and all regional subcortical WM (r_mean = 0.819, range, 0.664-0.928; P < 0.001). TBSS found significant correlations of WM-DTI metrics with myelination score during the range of 6-20 months, while no significant correlation was observed in 21-48 months. CONCLUSION: The modified T2WI-based screening scoring method is easily feasible to assess myelination progression of subcortical WM, especially suitable for children aged 6-20 months. It may show potential in identifying individual developmental abnormalities by scoring assessment in the future clinical practice.
Entities:
Keywords:
Children; DTI; Myelination; Subcortical white matter; T2WI
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