Diffusion Tensor MR Imaging Evaluation in Children with Developmental Delay

Abstract

Context: Developmental delay (DD) has a significant detrimental effect on the child’s quality of life. The critical time of diagnosis has a significant impact in preventing the decreased quality of life that the children with DD face, for which magnetic resonance imaging (MRI) with its new imaging techniques plays a pivotal role. Diffusion tensor imaging (DTI), a MRI technique, identifies microscopic features that are thought to be precursors to the ultimate stage of macroscopic tissue atrophy. Objectives: Spectrum of abnormal MRI brain findings was characterized, and role of DTI was evaluated in children with DD. Methods: Observational, descriptive study was performed on 80 children. Fifty cases of DD between the age of 1 month and 16 years, and 30 normal age-matched controls, underwent brain MRI with DTI for structural assessment of brain with measurement of fractional anisotropy (FA) of white matter tracts. “One sample t test” determined whether statistical significance existed between mean FA values of cases and controls. Results: Spectrum of hypoxic-ischemic insult and white matter abnormalities were the common findings seen in 21 (42%) and 19 (38%) children, respectively, amongst cases. On DTI, reduced FA was observed in white matter tracts of 24 (48%) children, most commonly in the corpus callosum of 13 (26%) children. Abnormal FA values in certain white matter tracts were observed in 6 (40%) out of 15 children with normal MRI brain. Conclusion: DTI exhibited the ability to pick up white matter tract abnormalities in the form of reduced FA values in children with DD, including some who showed structurally normal MRI.