92 Chapter 6 ABSTRACT Purpose: In 7 to 15 year old operated syndromic craniosynostosis patients we have shown the presence of microstructural anomalies in brain white matter by using DTI. To learn more about the cause of these anomalies, the aim of the study is to determine diffusivity values in white matter tracts in non-operated syndromic craniosynostosis patients aged 0-2 years compared to healthy controls. Methods: DTI datasets of 51 non-operated patients with syndromic craniosynostosis with a median [IQR] age of 0.40 [0.25] years, were compared with 17 control subjects with a median of 1.20 [0.85] years. Major white matter tract pathways were reconstructed with ExploreDTI fromMRI brain datasets acquired on 1.5 Tesla MRI system. Eigenvalues of these tract data were examined, with subsequent assessment of the affected tracts. Having syndromic craniosynostosis (versus control), gender, age, frontal occipital horn ratio (FOHR) and tract volume were treated as independent variables. Results: ʎ2 and ʎ3 of the tracts genu of the corpus callosum and the hippocampal segment of the cingulum bundle show a ƞ2 >0.14 in the comparison patients vs controls, which indicates a large effect on radial diffusivity. Subsequent linear regressions on radial diffusivity of these tracts show that age and FOHR are significantly associated interacting factors on radial diffusivity (p<0.025). Conclusion: Syndromic craniosynostosis shows not to be a significant factor influencing the major white matter tracts. Enlargement of the ventricles show to be a significant factor on radial diffusivity in the tracts corpus callosum genu and the hippocampal segment of the cingulate bundle. Abbreviations: AD - Axial Diffusivity FA – Fractional Anisotropy FGFR - Fibroblast Growth Factor Receptors FOHR – Frontal Occipital Horn Ratio MD - Mean Diffusivity RD - Radial Diffusivity sCS - syndromic Craniosynostosis Keywords: DTI, Diffusion Tensor Imaging, Tractography, Craniosynostosis, Syndrome
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