Yuzhen Zhang1, Yu Gao2, Minxiong Zhou3, Jie Wu4, Chishing Zee5, Dengbin Wang6. 1. Department of Radiology, Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 200092 Shanghai, P.R. China. Electronic address: zhangyuzhen7@hotmail.com. 2. Department of Radiology, Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 200092 Shanghai, P.R. China. Electronic address: gaoandyu@hotmail.com. 3. Shanghai University of Medicine & Health Sciences, 201318 Shanghai, P.R. China. Electronic address: zhoumin_ecnu@163.com. 4. Department of Pediatrics, Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 200092 Shanghai, P.R. China. Electronic address: wujie_xhyy@hotmail.com. 5. Department of Radiology, Keck School of Medicine, University of Southern California, California, United States. Electronic address: chishing@usc.edu. 6. Department of Radiology, Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 200092 Shanghai, P.R. China. Electronic address: dbwang8@aliyun.com.
Abstract
BACKGROUND AND PURPOSE: To investigate brain abnormalities in children with a clinical diagnosis of idiopathic generalized epilepsy (IGE) and unilateral interictal epileptiform discharges (IED) demonstrated on electroencephalography (EEG) by diffusional kurtosis imaging (DKI). MATERIALS AND METHODS: DKI images were obtained from 18 patients (n=9 each in the left and right hemispheres). Fractional anisotropy (FA), mean diffusivity (MD), and mean kurtosis (MK) maps were estimated through voxel-based analyses, and compared with 18 normal controls matched for age and sex. RESULTS: In the left side group, the significant differences of FA were in the left fusiform gyrus and occipital lobe of the white matter (WM). The significant differences of MD were in the left pons. The significant differences of MK were in the anterior cingulate gyrus, limbic lobe, gray matter (GM) and WM of the right cerebrum. In the right side group, the significant differences of FA were in the WM of the left cerebrum. MD identified differences in the frontal, temporal, occipital, and parietal lobes of both hemispheres, especially in the limbic system, fusiform gyrus, uncus, and parahippocampal gyrus. The significant differences of MK were in the GM of the right cerebrum, particularly in the rolandic operculum and frontal lobe. CONCLUSIONS: DKI is sensitive for the detection of diffusion abnormalities in both WM and GM of IGE in children. Secondary brain abnormalities may exist in regions outside the unilateral epileptogenic zone through the limbic epileptic network, and can be detected by DKI indices FA, MD and MK.
BACKGROUND AND PURPOSE: To investigate brain abnormalities in children with a clinical diagnosis of idiopathic generalized epilepsy (IGE) and unilateral interictal epileptiform discharges (IED) demonstrated on electroencephalography (EEG) by diffusional kurtosis imaging (DKI). MATERIALS AND METHODS: DKI images were obtained from 18 patients (n=9 each in the left and right hemispheres). Fractional anisotropy (FA), mean diffusivity (MD), and mean kurtosis (MK) maps were estimated through voxel-based analyses, and compared with 18 normal controls matched for age and sex. RESULTS: In the left side group, the significant differences of FA were in the left fusiform gyrus and occipital lobe of the white matter (WM). The significant differences of MD were in the left pons. The significant differences of MK were in the anterior cingulate gyrus, limbic lobe, gray matter (GM) and WM of the right cerebrum. In the right side group, the significant differences of FA were in the WM of the left cerebrum. MD identified differences in the frontal, temporal, occipital, and parietal lobes of both hemispheres, especially in the limbic system, fusiform gyrus, uncus, and parahippocampal gyrus. The significant differences of MK were in the GM of the right cerebrum, particularly in the rolandic operculum and frontal lobe. CONCLUSIONS: DKI is sensitive for the detection of diffusion abnormalities in both WM and GM of IGE in children. Secondary brain abnormalities may exist in regions outside the unilateral epileptogenic zone through the limbic epileptic network, and can be detected by DKI indices FA, MD and MK.