Myelin Imaging Changes In Patients With Neurosurgical Diseases

While a number of advanced imaging techniques, notably magnetization transfer, diffusion
tensor and quantitative T1 and T2 imaging (MTI, DTI, qT1 and qT2, respectively), have been
used previously to study white matter in neurosurgical diseases, these methods provide only
indirect, non-specific information related to myelin content. For example, these modalities
can tell when there is swelling that is affecting the movement of water, which may be
indicative of a process that would affect myelin, but they cannot tell us specific
information about the amount of myelin surrounding a nerve.

The investigators propose using a MRI sequence, mcDESPOT (multicomponent driven equilibrium
potential of T1 and T2) that utilizes a computer model that takes T1 and T2 sequences and
derives a quantitative value for the myelin content in the myelin sheath.

In the present program, the investigators propose adding the mcDESPOT sequence to the MRI
scanner in accordance with the MRI manufacturer's technical requirements. When this sequence
is added, the normal sequences are done first and mcDESPOT is done last. Although the
sequences obtained for mcDESPOT are sequences used in clinical practice, the flip-angles are
changed so that they cannot be read like a traditional image. Rather, the data have to be
post-processed by a computer in order to be able to derive myelin information.

McDESPOT is a 10 minute sequence that can be added to any MRI scanner. It is a obtained from
standard T1 and T2 sequences.

Inclusion Criteria:

1. Patient age range: 0-19

2. Patients who have an MRI ordered clinically and have one of the following conditions:
epilepsy, hydrocephalus, craniosynostosis or mild traumatic brain injury. Epilepsy,
hydrocephalus and craniosynostosis patients will be both newly diagnosed and chronic.
MTBI patients will be acute and chronic and defined as a glascow coma score (GCS) of
13-15.

3. Patients or their proxy should be capable of giving informed consent

Exclusion Criteria:

1. Unable to tolerate an extra 10 minutes of MRI scan