Diffusion tensor imaging findings in young children with benign external hydrocephalus differ from the normal population

Purpose To compare a pediatric population diagnosed with benign external hydrocephalus (BEH) to normal age-matched controls using diffusion tensor imaging (DTI) techniques. Methods We retrospectivelyidentified 17 BEH patients by specific clinical and neuroimaging criteria. Fractional anisotropy (FA) and mean diffusivity (MD) values obtained from DTI scans were compared to a population of age-matched controls andgroup differences were examined by mixed model analysis. A longitudinal comparison was completed on a subset that underwent multiple scans ( n = 8). Results In the genu of the corpus callosum (gCC), six of 15 BEH children had an FA value above the upper limit of 95% prediction interval, nine of 15 BEH children had MD values below the lower limit of 95% prediction interval. A similar trend applied to the other regions of interest (ROIs): splenium of the corpus callosum (sCC), ALIC, and PLIC. Statistical analysis demonstrated significant differences in FA within the gCC, sCC, and PLIC and in MD within the sCC between BEH patients and controls given ( P = 0.05). No statistical differences were identified at any ROIs at the later scans. Conclusions We found a significant increase in FA and decrease in MD in children with BEH compared with normal children in specific white matter (WM) ROIs, notably in the gCC and sCC; furthermore, in longitudinal comparison, DTI parameters normalized over time. The current study further demonstrates the ability of DTI to distinguish between subtle diffusion changes in periventricular white matter andestablishes preliminary objective radiographic parameters for watchful observation of patients with BEH.