Reference Trajectories of Extra-Axial Cerebrospinal Fluid during Childhood and Adolescence Defined in a Clinically Acquired MRI Dataset
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Extra-axial cerebrospinal fluid (eaCSF) refers to the CSF in the subarachnoid spaces that surrounds the brain parenchyma. Benign enlargement of the subarachnoid space (BESS), a condition marked by increased eaCSF thickness, has been associated with macrocephaly and may be associated with subdural collections. However, diagnosis of BESS is complicated by the lack of age-specific normative data which hinders rigorous investigation of its clinical associations. Growth charts of eaCSF could shed light on normal CSF dynamics while also providing a normative benchmark to assist the diagnosis of BESS and other associated conditions. Methods: We accessed clinically-acquired T1w MRI scans from 1226 pediatric patients to form a clinical control cohort. Nine scans from subjects with a diagnosis of BESS from a board-certified pediatric neuroradiologist were also reviewed. SynthSeg was used to segment each T1w scan into various tissue types, including eaCSF. Growth charts of eaCSF were modeled using the clinical control cohort. The confirmed BESS cases were then benchmarked against these charts to test the performance of eaCSF growth charts. Results: percentile for their age for at least one eaCSF measure. Centile scores were able to distinguish BESS cases from controls with an area under curve (AUC) greater than 0.95. Discussion: eaCSF thickness evolves in a dynamic pattern throughout childhood and adolescence. Patients with BESS can be differentiated from clinical controls using computational measurements of eaCSF thickness paired with normative modeling. Our findings demonstrate the feasibility of computational extraction of eaCSF with a potential point of clinical relevance, delineation of BESS diagnosis. Enhanced understanding of normative eaCSF is critical in further investigations its clinical associations.
DOI: 10.1148/ryai.250123
Language: English
Subfield: Cellular and Molecular Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: green
Funders: U.S. Department of Health and Human Services, Children's Hospital of Philadelphia, National Institutes of Health, Agency for Healthcare Research and Quality, National Institute of Mental Health, National Institute of Child Health and Human Development, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1838994524, ESTROGEN AND NEUROPROTECTION VIA AKT KINASE, G3259114089, CAPNET - Building Research Capacity in Child Abuse Pediatrics, G3637116492, G7763954546, Evaluating a novel approach-avoidance model of repetitive behaviors in autistic adolescents: A multi-method study, G8375182116, Radiomics for Clinically-Acquired Brain MRIs of Youth with Neurodevelopmental Disorders, Clinical and biologic health trajectories after early life adversity, A longitudinal study identifying psychological and service delivery targets to improve daily living skills and quality of life outcomes among autistic youth exiting high school, The Intellectual and Developmental Disabilities Research Center (IDDRC) at CHOP/Penn, Precision brain charts for imaging-genomics of schizophrenia and the psychosis spectrum
OpenAlex ID: W4417230975