Changes in the white-gray matter density difference in computed tomography associated with maturation

The attenuation of the x-ray beam in infantile brain tissue is markedly lower than in adults, so the CT image in infants, particularly in the newborn, seems to indicate demyelinating diseases. Therefore, the evaluation of nonpathological scans of infants and adults was performed in order to establish baseline numerical data on white and gray matter differentiation associated with maturation. One hundred and nine normal cases with no motion artifacts were selected. The age distribution was from 39 weeks to 40 years, as shown in Fig. 1. The Hitachi CT-H 250 tomograph was used for all the patient scans. The x-ray tube was operated at 120 kV and 30 mA. The thickness of each slice was 10 mm. The patients were scanned parallel with the canthomeatal line. The CT numbers are displayed on the EMI scale, in which water is zero and bone is +500. The mean CT numbers and the standard deviation were calculated by means of a computer on a horizontal plane through the pineal body; the following regions were selected for computation: White matter: preventricular frontal area. 44 mm2 (36 pixels). Gray matter: head of the caudate nucleus and the thalamus. 24 mm2 (20 pixels). The mean CT number for white matter was 13.5 +- 0.5 in the newborn and 16.8 +- 0.4 in adults. These numbers increased very rapidly during the 2nd month after birth and reached the adult value by 13 years. On the other hand, the mean CT number for gray matter was 15.6 +- 0.6 in the newborn and 19.7 +- 0.4 in adults. These numbers increased only gradually after birth and reached maximum value at 20 years, These results are probably due to a decrease in the water content per unit of volume and an increase in brain solids (protein, RNA and myelin) rather than to a decrease in the extracellular space associated with maturation. The difference between the average white and gray value was also studied. The white-gray difference was lowest (1.6 units) at 2 months and highest (2.9 units) in adults. (author)