Article Figures & Data
Figures
- FIG 1.
DWI signal hyperintensity in the fornix-fimbria. MR imaging study of a 7.5-month-old girl with hypsarrhythmia. Consecutive diffusion-weighted images from top (A) to bottom (E) show signal hyperintensity of the fornices (arrows) and fimbriae (arrowheads). F, A magnified view shows DWI hyperintensity involving the fornix-fimbria complex. Also notable is mild volume loss.
- FIG 2.
DWI signal intensity in the fornix-fimbria in a control group versus patients with high signal intensity. Two examples of children (patient 1, A–D; patient, 2 E–H) with high signal intensity detected in the fornix-fimbria on DWI, in axial slices from top to bottom. D and H, Magnified view at the level of the forniceal body (arrow) shows high signal intensity (compared with the adjacent caudate, asterisk). A third patient (I–L) with normal signal intensity of the fornix-fimbria on DWI. L, An enlarged image of the forniceal body (arrow). Usually, the DWI signal intensity of the fornix is approximately the same as that of the adjacent caudate nucleus (asterisk).
- FIG 3.
Changes in DWI signal intensity of the fornix-fimbria with time. A brain MR imaging study of a child with a low-grade cervicomedullary tumor on a DWI sequence. The body of the fornix (arrows) is shown in 3 follow-up studies performed at 3 months of age (A), 13 months of age (B), and 24 months of age (C). Fornix DWI hyperintensity is noted only at 13 months of age. Comparing the signal intensity of the head of the caudate nucleus (asterisk) shows similar signals at 3 and 24 months of age and a hypersignal at 13 months of age.
- FIG 4.
ADC measurement in the fornix (A and B) and fimbria (C and D). After detecting DWI hyperintensity on the fornix (A) or fimbria (C), we placed an ROI manually on the corresponding ADC image while trying to avoid CSF contamination and obtained the measurements. Similar measurements were performed for the control group using anatomic guidance. AR indicates area; AV, average.
Tables
Characteristics No. (%) Age Median 10 months Range 12 days to 22 months Sex Female 37 70 Male 16 30 MR imaging magnet 1.5T 9 17 3T 44 83 Follow-up studies Patients with a follow-up MR imaging 4 7.5 Common findings on MR imaginga Normal scan findings 20 47 Parenchymal volume loss 8 15 ↵a Additional imaging findings were variable and included old infarcts, subdural collections, hydrocephalus, tuberous-sclerosis stigmata, and heterotopia.
- Table 2:
Indications for performing brain MR imaging in 53 children with DWI hyperintensity in the fornix-fimbria complexa
Indications No. % Seizures 14 26.5 Developmental delay/FTT 8 15 Sensorineural hearing loss 4 7.5 Hemiparesis 2 4 Nystagmus 2 4 Torticollis 3 5.5 Acute lymphocytic leukemia 3 5.5 Macrocephaly 2 4 Microcephaly 1 2 Hypoxic-ischemic insult 1 2 Suspected nonaccidental injury 1 2 Suspected Sturge-Weber syndrome 1 2 Strabismus 1 2 Brain tumor 1 2 Suspected Miller Fisher syndrome 1 2 Drowsiness 1 2 Microtia 1 2 Tuberous sclerosis 1 2 Ventriculomegaly 3 5.5 Meningitis 2 4 Note:—FTT indicates failure to thrive.
↵a Children 0–2 years of age; mean, 10 months of age.
