Age-related development of meningeal lymphatic vessels in children assessed by 3D T2 FLAIR MRI

Meningeal lymphatic vessels (mLVs) are closely associated with the development of numerous neurological diseases. While age has been identified as a crucial factor that influences the meningeal lymphatics, their developmental characteristics in children of different ages remain unknown. Therefore, the aim of this study was to analyze the signal intensities and thicknesses of mLVs from three-dimensional T2-fluid-attenuated inversion recovery magnetic resonance imaging (3D T2-FLAIR MRI) sequences in children of different ages in order to ascertain their developmental characteristics. Data were retrospectively collected from 90 children (45 males and 45 females) who underwent MRI for suspected epilepsy between September 2022 and September 2023. The signal intensities and thicknesses of dorsal and ventral mLVs were measured from 3D T2-FLAIR MRI sequences. Participants were subsequently assigned to groups based on age or sex for intergroup comparisons to assess the development of mLVs in children of different ages and to determine whether any changes were sex-specific. This study included 90 children (45 males and 45 females) who met the inclusion criteria. The median age was 4 years (range: 4 months to 12 years).The result shows that the SI and thicknessof the dorsal mLVs in children increased with age and were significantly different (P<0.001). A similar trend was observed for the SI and thickness of the ventral mLVs. The ratio of dorsal to ventral mLVs exhibited statistically significant decreasing trends with respect to age (P < 0.001), as did the SI and thickness. Further analysis revealed statistically significant correlations between the age of the patients and the thickness and SI of both ventraland overall mLVs. There was no statistically significant difference in the SI (P = 0.262) or thickness (P = 0.805) of the mLVs between sexes. Analysis of the 3D T2-FLAIR MRI sequences revealed that the thickness and SI of the mLVs increased over time in children and was significantly correlated with age. Moreover, the ventral mLVs exhibited significantly greater growth compared to that of the dorsal mLVs. There were no differences in the mLV measurements between males and females.