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Neuropediatrics 2017; 48(05): 340-349
DOI: 10.1055/s-0037-1603979
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Pitfalls in Diffusion-Weighted and Diffusion Tensor Imaging of the Pediatric Brain

Nivedita Agarwal
1   Department of Radiology, Hospital of Santa Maria del Carmine,Azienda Provinciale per i Servizi Sanitari, Rovereto, Trento, Italy
2   Section of Pediatric Neuroradiology, Division of pediatric Radiology, The Johns Hopkins School of Medicine, Baltimore, Maryland, United States
,
Aylin Tekes
2   Section of Pediatric Neuroradiology, Division of pediatric Radiology, The Johns Hopkins School of Medicine, Baltimore, Maryland, United States
,
Andrea Poretti   †
2   Section of Pediatric Neuroradiology, Division of pediatric Radiology, The Johns Hopkins School of Medicine, Baltimore, Maryland, United States
,
Avner Meoded
2   Section of Pediatric Neuroradiology, Division of pediatric Radiology, The Johns Hopkins School of Medicine, Baltimore, Maryland, United States
3   Department of Radiology Johns Hopkins All Children's Hospital, St. Petersburg, Florida, United States
,
Thierry A.G.M. Huisman
2   Section of Pediatric Neuroradiology, Division of pediatric Radiology, The Johns Hopkins School of Medicine, Baltimore, Maryland, United States
› Author Affiliations
Further Information

Publication History

20 March 2017

10 May 2017

Publication Date:
06 July 2017 (online)

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Abstract

Diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) are advanced magnetic resonance imaging (MRI) techniques that are based on differences in the diffusion rate of water molecules in brain tissue. DWI and DTI are widely used in pediatric neuroradiology to evaluate a wide spectrum of brain diseases. The interpretation of DWI and DTI images requires a basic knowledge of the underlying physics to detect potential pitfalls and avoid misinterpretation. Several DWI pitfalls are related to the dependency of DWI images not only on the diffusivity of water molecules, but also on various additional MRI phenomena such as the T1- and T2- relaxation characteristics and MRI-related artifacts. In addition, knowledge about the age of the child and interval between the onset of injury and acquisition of DWI/DTI images is important. Finally, qualitative evaluation (“eye-balling”) maybe misleading, and the application of quantitative measurements of DTI scalars may avoid misdiagnosis.

Keywords

brain - children - neuroimaging - diffusion-weighted imaging - diffusion tensor imaging - pitfalls - artifacts

Note

The study was performed at the Johns Hopkins University.


† Deceased.


Supplementary Material

 

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