Diffusion tensor imaging demonstrated radiologic differences between diplegic and quadriplegic cerebral palsy

Little information is available on the use of imaging for the classification of cerebral palsy patients. The present study examined the radiological differences between quadriplegic cerebral palsy patients (QCP), diplegic cerebral palsy patients (DCP) and normal control subjects (NC) by performing diffusion tensor imaging (DTI) of the corticospinal tract (CST) of upper and lower extremities. Twenty-three cerebral palsy patients (11 QCP, 12 DCP) and 12 NC were enrolled. DTI were scanned using a 1.5 T and the CST images were analyzed using FMRIB software. We measured the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the CST. Compared to DCP and NC, QCP had decreased mean FA and increased mean ADC values of the CSTs of upper and lower extremities. The mean FA values of the lower extremities in DCP were significantly decreased, compared to NC; however this was not observed for the mean FA value of the upper extremities. The DTI results of the CST in QCP and DCP significantly corresponded with their typical clinical manifestation. DTI may thus be a very powerful modality to assess the state of CST in cerebral palsy patients.