Jija S James1, Ashalatha Radhakrishnan2, Bejoy Thomas1, Mini Madhusoodanan3, Chandrashekharan Kesavadas1, Mathew Abraham3, Ramshekhar Menon3, Chaturbhuj Rathore3, George Vilanilam3. 1. Department of Imaging and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India. 2. R Madhavan Nayar Centre for Comprehensive Epilepsy Care, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India. Electronic address: drashalatha@sctimst.ac.in. 3. R Madhavan Nayar Centre for Comprehensive Epilepsy Care, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India.
Abstract
PURPOSE: Whether Meyer's loop (ML) tracking using diffusion tensor imaging tractography (DTIT) can be utilized to avoid post-operative visual field deficits (VFD) after anterior temporal lobectomy (ATL) for drug-resistant temporal lobe epilepsy (TLE) using a large cohort of controls and patients. Also, we wanted to create a normative atlas of ML in normal population. METHODS: DTIT was used to study ML in 75 healthy subjects and 25 patients with and without VFD following ATL. 1.5T MRI echo-planar DTI sequences with DTI data were processed in Nordic ICE using a probabilistic method; a multiple region of interest technique was used for reconstruction of optic radiation trajectory. Visual fields were assessed in patients pre- and post-operatively. RESULTS: Results of ANOVA showed that the left ML-TP distance was less than right across all groups (p = 0.01). The average distance of ML from left temporal pole was 37.44 ± 4.7 mm (range: 32.2-46.6 mm) and from right temporal pole 39.08 ± 4.9 mm (range: 34.3-49.7 mm). Average distance of left and right temporal pole to tip of temporal horn was 28.32 ± 2.03 mm (range: 26.4-32.8 mm) and was 28.92 ± 2.09 mm, respectively (range: 25.9-33.3 mm). If the anterior limit of the Meyer's loop was ≤38 mm on the right and ≤35 mm on the left from the temporal pole, they are at a greater risk of developing VFDs. CONCLUSIONS: DTIT is a novel technique to delineate ML and plays an important role in planning surgical resection in TLE to predict post-operative visual performance and disability.
PURPOSE: Whether Meyer's loop (ML) tracking using diffusion tensor imaging tractography (DTIT) can be utilized to avoid post-operative visual field deficits (VFD) after anterior temporal lobectomy (ATL) for drug-resistant temporal lobe epilepsy (TLE) using a large cohort of controls and patients. Also, we wanted to create a normative atlas of ML in normal population. METHODS: DTIT was used to study ML in 75 healthy subjects and 25 patients with and without VFD following ATL. 1.5T MRI echo-planar DTI sequences with DTI data were processed in Nordic ICE using a probabilistic method; a multiple region of interest technique was used for reconstruction of optic radiation trajectory. Visual fields were assessed in patients pre- and post-operatively. RESULTS: Results of ANOVA showed that the left ML-TP distance was less than right across all groups (p = 0.01). The average distance of ML from left temporal pole was 37.44 ± 4.7 mm (range: 32.2-46.6 mm) and from right temporal pole 39.08 ± 4.9 mm (range: 34.3-49.7 mm). Average distance of left and right temporal pole to tip of temporal horn was 28.32 ± 2.03 mm (range: 26.4-32.8 mm) and was 28.92 ± 2.09 mm, respectively (range: 25.9-33.3 mm). If the anterior limit of the Meyer's loop was ≤38 mm on the right and ≤35 mm on the left from the temporal pole, they are at a greater risk of developing VFDs. CONCLUSIONS: DTIT is a novel technique to delineate ML and plays an important role in planning surgical resection in TLE to predict post-operative visual performance and disability.
Authors: Jose Leon-Rojas; Isabel Cornell; Antonio Rojas-Garcia; Felice D'Arco; Jasmina Panovska-Griffiths; Helen Cross; Sotirios Bisdas Journal: BJR Open Date: 2021-07-05
Authors: Lee B Reid; Eloy Martínez-Heras; Jose V Manjón; Rosalind L Jeffree; Hamish Alexander; Julie Trinder; Elisabeth Solana; Sara Llufriu; Stephen Rose; Marita Prior; Jurgen Fripp Journal: Hum Brain Mapp Date: 2021-09-21 Impact factor: 5.038