MR assessment of myelination in infants and children: usefulness of marker sites.

Abstract

A retrospective study was made of 60 patients, 1 month to 3 years old, to determine the normal progression of white matter myelination on MR imaging. All examinations were performed with a 1.5-T unit, and axial T1- and T2-weighted images were evaluated in each patient. Multiple sites in the cerebral hemisphere and cerebellum were examined in each case for the presence and degree of myelination. The results show that MR imaging is sensitive to the early changes of white matter myelination, and imaging patterns correlate with known patterns from pathologic studies. At the time of birth in a full-term infant the posterior limb of the internal capsule, central corona radiata, and cerebellar peduncles show visible myelination. Myelination in the centrum semiovale then proceeds anteriorly and posteriorly. Both T1- and T2-weighted images show these changes, which are best explained by a decrease in the water content of white matter as myelination progresses. Knowledge of these normal myelination patterns is essential in evaluating MR imaging studies in infants and children and in diagnosing delayed myelination.