Journal List > J Korean Soc Radiol > v.62(5) > 1086754

Kang, Choi, Jo, Kang, Ha, and Nam: Chronological Changes of the Signal Intensities of White Matter on the FLAIR Images of Infants

Abstract

Purpose

To assess the pattern of chronological change for the signal intensities of white matter on the FLAIR images of infants.

Materials and Methods

FLAIR, T1- and T2-weighted images of 119 infants (newborn to 24 months age) were obtained by using a 1.5 T MRI machine. From these images, the signal intensities of 9 different white matter regions were compared to those of the adjacent gray matter and the signal intensities of each image were scored from 1 to 5.

Results

The FLAIR images show high signal intensity for the cerebellar peduncle and posterior limb of the internal capsule at birth, but changed to low signal intensities in 2 to 3 months. The low signal intensities of the occipital-, parietal-, and frontal deep white matter and subcortical white matter changed to high signal intensities in 2 months, and they returned to low signal intensities in 10, 11, 12 and 19 months, respectively.

Conclusion

The signal intensity of the white matter of infants showed peculiar chronologic changes on the FLAIR images. This knowledge could be helpful for the differentiation of normal white matter development and the lesions that mimic white matter disease in infants.

Figures and Tables

Fig. 1

Signal intensity curves as a function of age in months on the T1-, T2-weighted and FLAIR images for each of the white matter regions as compared with the adjacent gray matter; dorsal pons (A), cerebellar peduncle (B), posterior limb of internal capsule (C), centrum semiovale (D), anterior limb of the internal capsule (E), occipital deep white matter (F), parietal deep white matter (G), frontal deep white matter (H), subcortical white matter (I). (A)-(E); Biphasic pattern, (F)-(I); Triphasic pattern. (5: marked high signal, 4: mild high signal, 3: iso-signal, 2: mild low signal, 1: marked low signal)

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Fig. 2

Example of the white matter signal intensity changes according to the age in months; the T1-weighted (left), T2-weighted (middle), and FLAIR (right) images of a 9-day-old newborn (A), a 3-month-old infant (B), an 8-month-old infant (C) and a 12-month-old infant (D). Note the progression of the triphasic signal intensity change in the deep white matter on the FLAIR images (arrows) and the signal intensities of the deep white matter on the FLAIR image of the 3-month-old (B) and 8-month-old infants (C) looks deceivingly like a T1-weighted images except for the internal capsule.

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Fig. 3

Examples of the subcortical white matter signal intensity changes according to the age in months on the FLAIR images: an 18-month-old infant (A) and a 20-months-old infant (B). Note the signal intensity of the subcortical white matter (arrows) showing high signal intensity in an 18-monthold infant, as compared with low signal intensity in a 20-month-old infant.

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Table 1

The Age Distribution and the Number of Cases

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The age distribution was grouped every two months until 8 months and every 4 months up to 24 months of age. *One of the infant underwent MRI twice, at the age of 3 months and 7 months.

Table 2

The Average Scores of Signal Intensity in each of the White Matter Regions according to the Ages in Months

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There is no case for 22 months of age.

DP: dorsal pons, CP: cerebellar peduncle, PI: posterior limb of internal capsule,

AI: anterior limb of internal capsule, CS: centrum semiovale, O: occipital deep white matter, F: frontal deep white matter, P: parietal deep white matter, SC: subcortical white matter

Table 3

The Age of the Signal Changes on the T1, T2-weighted and FLAIR Images in each of the White Matter Regions

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Biphasic pattern: Signal intensity change of white matter, initially hyperintense to hypointense. Triphasic pattern: Signal intensity change of white matter, initially hypointense to hyperintense, and finally to hypointense.

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