RT Journal Article SR Electronic T1 Quantification of DTI in the Pediatric Spinal Cord: Application to Clinical Evaluation in a Healthy Patient Population JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology SP 1236 OP 1241 DO 10.3174/ajnr.A6104 VO 40 IS 7 A1 B.B. Reynolds A1 S. By A1 Q.R. Weinberg A1 A.A. Witt A1 A.T. Newton A1 H.R. Feiler A1 B. Ramkorun A1 D.B. Clayton A1 P. Couture A1 J.E. Martus A1 M. Adams A1 J.C. Wellons III A1 S.A. Smith A1 A. Bhatia YR 2019 UL http://www.ajnr.org/content/40/7/1236.abstract AB BACKGROUND AND PURPOSE: The purpose of the study is to characterize diffusion tensor imaging indices in the developing spinal cord, evaluating differences based on age and cord region. Describing the progression of DTI indices in the pediatric cord increases our understanding of spinal cord development.MATERIALS AND METHODS: A retrospective analysis was performed on DTI acquired in 121 pediatric patients (mean, 8.6 years; range, 0.3–18.0 years) at Monroe Carell Jr. Children's Hospital at Vanderbilt from 2017 to 2018. Diffusion-weighted images (15 directions; b = 750 s/mm2; slice thickness, 5 mm; in-plane resolution, 1.0 × 1.0 mm2) were acquired on a 3T scanner in the cervicothoracic and/or thoracolumbar cord. Manual whole-cord segmentation was performed. Images were masked and further segmented into cervical, upper thoracic, thoracolumbar, and conus regions. Analyses of covariance were performed for each DTI-derived index to investigate how age affects diffusion across cord regions, and 95% confidence intervals were calculated across age for each derived index and region. Post hoc testing was performed to analyze regional differences.RESULTS: Analyses of covariance revealed significant correlations of age with axial diffusivity, mean diffusivity, and fractional anisotropy (all, P < .001). There were also significant differences among cord regions for axial diffusivity, radial diffusivity, mean diffusivity, and fractional anisotropy (all, P < .001).CONCLUSIONS: This research demonstrates that diffusion evolves in the pediatric spinal cord during development, dependent on both cord region and the diffusion index of interest. Future research could investigate how diffusion may be affected by common pediatric spinal pathologies.ADaxial diffusivityANCOVAanalyses of covarianceDTIdiffusion tensor imagingEPIecho planar imagingFAfractional anisotropyFOVfield-of-viewGMgray matterMDmean diffusivityPMMpopulation marginal meansRDradial diffusivitySNRsignal to noise ratioWMwhite matter