Diffusion tensor imaging demonstrates focal lesions of the corticospinal tract in hemiparetic patients with cerebral palsy

Diffusion Tensor Imaging–Demonstrated Differences between Hemiplegic and Diplegic Cerebral Palsy with Symmetric Periventricular Leukomalacia

“…In addition, we used asymmetric values such as asymmetric anisotropy index and asymmetric mean diffusivity index to investigate degrees of asymmetry between the right and left CSTs. Another study conducted in 2007 investigated asymmetric properties in hemiplegic CP and found that asymmetric anisotropy index and asymmetric mean diffusivity index values were higher in hemiplegic patients than in age-matched controls 14 ; their findings correspond to our results. Originally, we believed that relative asymmetric values provide a more appropriate means of revealing differences between right and left CSTs than FA or ADC values because patients of the same age exhibit growth and developmental differences.…”

“…DTT is a 3D visualized version of DTI and thus provides concrete descriptions of the architecture and integrity of the CST. [14][15][16][17] Several previous studies have demonstrated that DTI provides a powerful means of detecting white matter lesions and evaluating the states of neural tracts. 6,7,[18][19][20][21][22][23][24] In the current study, we sought to determine whether DTT can differentiate between hemiplegic and diplegic CP in patients who display symmetric PVL on conventional MR imaging.…”

Medial Lemniscus Lesion in Pediatric Hemiplegic Patients without Corticospinal Tract and Posterior Thalamic Radiation Lesion

“…Pediatric patients with hemiplegic CP show abnormalities of muscle tone, posture, and movement pattern in affected limbs, which are known as a consequence of lesions in the sensorimotor cortex or subcortical deep white matter tract [2,3,4,5,6,7]. These neurologic abnormalities confined to only unilateral limbs in pediatric patients lead to discrepancy of growth and functional development [8,9,10,11,12].…”

“…Many previous studies of pediatric hemiplegic patients with CP investigated the relationship between injury of the corticospinal tract (CST) and clinical hemiplegic pattern [5,6,13,14,15,16,17,18,19,20]. Damage to the CST may lead to motor weakness, loss of acquired skillful movement, functional impairment, and spasticity of involving limbs [5,6,13,14,15,16,17,18,19,20,21,22,23,24].…”

Imagem por tensores de difusão em crianças com leucomalácia periventricular

“…Son et al [58] avaliaram quatro pacientes com paralisia cerebral com imagens convencionais normais em que lesões focais foram identificadas somente pela tratografia, demonstrando assimetria dos parâmetros de anisotropia fracionada e difusibilidade ao longo dos tratos, ressaltando a maior sensibilidade do método, sua concordância com o quadro clínico e a possibilidade de identificação de lesões focais na substância branca, tal qual na leucomalácia periventricular, em pacientes nascidos a termo.…”