Age-Related Changes in Tissue Value Properties in Children: Simultaneous Quantification of Relaxation Times and Proton Density Using Synthetic Magnetic Resonance Imaging

Objectives The properties of brain tissue undergo dynamic changes during maturation. T1 relaxation time (T1), T2 relaxation time (T2), and proton density (PD) are now simultaneously quantifiable within a clinically acceptable time, using a synthetic magnetic resonance imaging (MRI) sequence. This study aimed to provide age-specific reference values for T1, T2, and PD in children, using synthetic MRI. Materials and Methods We included 89 children (median age, 18 months; range, 34 weeks of gestational age to 17 years) who underwent quantitative MRI, using a multidynamic, multiecho sequence on 3 T MRI, between December 2015 and November 2016, and had no abnormal MRI/neurologic assessment findings. T1, T2, and PD were simultaneously measured in each of the 22 defined white matter and gray matter regions of interest. The measured values were plotted against age, and a curve fitting model that best explained the age dependence of tissue values was identified. Age-specific regional tissue values were calculated using a fit equation. Results The tissue values of all brain regions, except cortical PD, decreased with increasing age, and the robust negative association was best explained by modified biexponential model of the form Tissue values = T₁ × exp (-C₁ × age) + T₂ × exp (-C₂ × age). The quality of fit to the modified biexponential model was high in white matter and deep gray matter (white matter, R² = 97%-99% [T1], 88%-95% [T2], 88%-97% [PD]; deep gray matter, R² = 96%-97% [T1], 96% [T2], 49%-88% [PD]; cortex, 70%-83% [T1], 87%-90% [T2], 5%-27% [PD]). The white matter and deep gray matter changed the most dynamically within the first year of life. Conclusions Our study provides age-specific regional reference values, from the neonate to adolescent, of T1, T2, and PD, which could be objective tools for assessment of normal/abnormal brain development using synthetic MRI.