Pediatric diffusion and diffusion tensor imaging

Abstract

Diffusion analysis and imaging is yet another nuclear magnetic resonance technique that has moved from the chemistry laboratory to the forefront of radiological imaging, diagnosis and research. A symposium on diffusion imaging is pertinent to readers ofPediatric Radiology because much of the clinical and research application of diffusion, including diffusionweighted imaging (DWI) and diffusion tensor imaging (DTI), is applicable to infants and children. DWI of the brain makes possible the rapid diagnosis of a wide spectrum of pathological entities and gives insight into the prognosis of infants and children with a variety of insults to the central nervous system. The study of brain development utilizing parameters such as apparent diffusion coefficient (ADC) and fractional anisotropy (FA) allows quantitation of normal and abnormal development of brain structure. DTI with fiber tracking allows visualization of the normal and abnormal development of cerebral white matter pathways and has potential clinical application in the detection of displaced and infiltrated functional pathways in children with cerebral neoplasia. Tim Roberts and Erin Simon Schwartz present a very clear and understandable synopsis of the physical principles, terminology, and application of diffusion imaging in the brain. Susan Benedict gives a pediatric neurologist’s perspective on the utility of diffusion imaging in a busy clinical practice. Rick Robertson summarizes the increasing utility of DWI in the pediatric (and fetal) brain, and Nancy Rollins shows beautiful images of DTI and fiber tracking, displaying examples of normal and pathological brain development. Finally, as we see in the article by MacKenzie et al. diffusion imaging has exciting potential application outside the central nervous system in the pediatric musculoskeletal system. Pediatr Radiol (2007) 37:733 DOI 10.1007/s00247-007-0466-5