Diffusion Kurtosis Imaging of Microstructural Alterations in the Brains of Paediatric Patients with Congenital Sensorineural Hearing Loss

Wenbin Zheng,Renhua Wu,Lexing Huang,Chunxiao Wu

doi:10.1038/s41598-017-01263-9

Abstract

Our aim was to assess microstructural alterations in the cerebrums of paediatric patients with congenital sensorineural hearing loss (SNHL) using diffusion kurtosis imaging (DKI). Seventy-two paediatric SNHL patients and 38 age-matched healthy volunteers were examined via DKI using a 3.0 T magnetic resonance (MR) imager. Fractional anisotropy (FA) and mean kurtosis (MK) values were computed for 12 cerebral regions in both the controls and the SNHL patients. Compared with patients below age 3, patients in the older age group were found to have more significant differences in MK than in FA, and these appeared in more major areas of the brain. In contrast, in 1- to 3-year-old children, a few major brain areas exhibited differences in FA, but none exhibited appreciable differences in MK. There were significant decreases in the FA or MK values (P < 0.05, all) in more areas of the brain in patients with lesions than in patients with normal-appearing brains. DKI offers comprehensive measurements for quantitative evaluation of age-related microstructural changes in both white and grey matter in SNHL patients. DKI scans of children with SNHL exhibiting significant decreases in MK might play an important role in evaluating the severity of developmental delay.

Highlights

Previous diffusion tensor imaging (DTI) studies demonstrating changes in fractional anisotropy (FA) in children with sensorineural hearing loss (SNHL) have revealed that such children have a developmental delay in the myelination of the auditory neural pathway, suggesting that early CI might be more effective than later CI in restoring hearing in children with SNHL8–10
The mean kurtosis (MK), as an imaging marker, has been demonstrated to be sensitive to structural changes in both anisotropic tissue, such as white matter (WM), and isotropic tissue, such as grey matter (GM), affording information about tissue microarchitecture that is complementary to measures such as the Fractional anisotropy (FA) and mean diffusivity (MD)[11,12,13,14,15,16]
Among 20 children who had received CIs, we found that 6 had brain lesions in the white matter according to conventional MRI

Summary

Introduction

Previous diffusion tensor imaging (DTI) studies demonstrating changes in fractional anisotropy (FA) in children with SNHL have revealed that such children have a developmental delay in the myelination of the auditory neural pathway, suggesting that early CI might be more effective than later CI in restoring hearing in children with SNHL8–10. Diffusion-weighted techniques that exploit diffusional non-Gaussianity have been developed, and diffusion kurtosis imaging (DKI), which measures both the Gaussian and non-Gaussian properties of water diffusion, provides sensitive and comprehensive measurements for the quantitative evaluation of age-related www.nature.com/scientificreports/. We used DKI as a novel imaging tool to study children with SNHL and estimate differences in the microstructural integrity of the auditory pathway, auditory cortex, language-related cortex, and learning and memory function–related cortex during the first 7 years of life. We sought to determine whether DKI could detect preoperative microstructural changes in the white and grey matter of children who were to receive CIs and whether it could provide helpful additional information about the indication and selection of patients to receive a cochlear implant

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