Fiber Tractography and Diffusion Tensor Imaging in Children with Agenesis and Dysgenesis of Corpus Callosum: A Clinico-Radiological Correlation

Background Corpus callosum is the largest commissure in human brain. It consists of tightly packed white matter tracts connecting the two cerebral hemispheres.  In this study we aimed to evaluate role of fiber tractography (FT), and diffusion tensor imaging (DTI) in pediatric patients with corpus callosum anomalies and correlate findings with clinical presentation. Materials and Methods This prospective study included 115 children with clinical presentations and CT findings suggested corpus callosum anomalies. Their ages ranged between 2 and 12 year-old. They referred from Pediatric Neurology unit to Radiology Department in Minia University hospital for children, Minia (Egypt) from April 2018 till December 2018. They underwent MRI fiber tractography and diffusion tensor imaging after approval of ethical committee of our institution and informed consent form patients’ parents. Results Our study included 42 (36.5 %) males and 73 (63.5 %) females. They were reviewed for corpus callosum anomalies according to Hanna classification, the commonest was hypoplasia without dysplasia 37/115 (32 %). Using DTI and FT, corpus callosum fiber defects were classified into fronto-rostral, caudal and whole body defect. Significant statistical correlation was found between ADHD, autism and loss of fronto-rostral fibers. Epilepsy and developmental delay were correlated to whole body defect and caudal fiber tract defects. Conclusion Based on the results, Fiber tractography and diffusion tensor imaging are newly developed promising techniques. They proved high accuracy in localization of exact affected corpus callosum white matter tract. They help to predict prognosis of patients that could not be explained by morphological changes seen in conventional MRI.