Conclusion
MR imaging is the first imaging modality to be able to demonstrate the morphological and structural changes in the maturing brain, in the fetus, and in the term-born infant. The fetal brain cellularity first and later, the mass production on myelin with its effects on T1 and the T2, produce age-specific images that make it possible to evaluate the course of brain maturation. This evaluation has opened new diagnostic avenues, since the sensitivity of the oligodendrocytes to injury, as well as the involvement of myelin in numerous pathologic processes, make the evaluation of maturation an essential element of the imaging approach to the pathology. However, there are a few restrictions to be remembered. T1 and T2 images reflect two different things, not necessarily parallel, and should be used as such. Conventional MR images are composite, non-quantitative images, reflecting only the myelination of diverse areas relative to others: it is therefore a biased picture during the entire course of development. This image is technology-dependent, and pictures are not necessarily exactly comparable from one center to the other. Also, MR imaging is blind to the development, and to slight myelin anomalies, that occur after infancy. Finally, the signal in the images equates to the degree of myelination only in normal subjects, as a “high T2”, or a “low T1” signal are not specific, reflecting only the relative concentration of myelin and water, regardless of the mechanism, be it for example an increase of water (edema), or a loss of axons (hence also of myelin). Nevertheless, bearing these restrictions in mind not to “over-read” the images, MRI is an efficient tool, that has allowed a completely new view of brain pathologies in the fetus and the developing infant.
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Raybaud, C. (2005). MR Imaging of Brain Development. In: Filippi, M., De Stefano, N., Dousset, V., McGowan, J.C. (eds) MR Imaging in White Matter Diseases of the Brain and Spinal Cord. Medical Radiology Diagnostic Imaging. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-27644-0_11
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