Ternary Tensor Shape Analysis of White Matter Hyperintensities: A Pilot Study

Purpose: This pilot study evaluated the utility of ternary tensor shape analysis based on linearity (Cl), planarity (Cp), and sphericity (Cs) to identify microstructural alterations in white matter hyperintensities (WMHs).Materials and Methods: Tensor parameters such as Cl, Cp, Cs, fractional anisotropy (FA), and apparent diffusion coefficient (ADC) of the WMH group were compared with those of the normal control group across eight regions of interest (ROIs), including the putamen, cingulum, superior corona radiata (SCR), superior longitudinal fasciculus (SLF), corpus callosum (CC), internal capsule, inferior longitudinal fasciculus, and middle cerebellar peduncle.Results: Compared to controls, the WMH group exhibited significant microstructural differences across multiple diffusion parameters.The composite tensor shape index derived from principal component analysis of Cl, Cp, and Cs was significantly elevated in the putamen (p = 0.041), SLF (p = 0.015), and CC (p = 0.015), reflecting a shift toward more isotropic diffusion.Clustered heatmap analysis further identified the SLF, CC, and SCR as regions with the most pronounced WMH-related alterations across first principal component, FA, and ADC.Conclusion: Ternary tensor shape analysis based on Cl, Cp, and Cs effectively captured WMH-related microstructural changes and showed potential as an imaging tool complementary to conventional diffusion metrics.