Keran Ma1, Xiaonan Zhang1, Huiting Zhang2, Xu Yan2, Ankang Gao1, Chengru Song1, Shaoyu Wang2, Yajun Lian3, Jingliang Cheng4. 1. Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China. 2. MR Scientific Marketing, Siemens Healthcare, Shanghai, 201318, China. 3. Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China. 4. Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China. Electronic address: cjlcjr123@163.com.
Abstract
PURPOSE: To compare MRI volume measurements, FLAIR image intensity, Diffusion tensor imaging (DTI) and mean apparent propagator (MAP)-MRI measurements in hippocampus ipsilateral and contralateral to the epileptogenic focus for non-invasive lateralization of temporal lobe epilepsy (TLE) and also compare these DTI and MAP-MRI measurements to cognitive function. METHOD: A cohort of patients with unilateral TLE and aged-and gendered-matched controls were enrolled in this retrospective study. T1-weighted MPRAGE data for the volume, FLAIR image intensity, DTI and MAP-MRI parameters were performed for bilateral hippocampi of all subjects. The sensitivity, specificity, lateralization ratios and Cohen's d effect sizes of all MR measurements were calculated. Pearson correlation analysis was performed to compare DTI and MAP-MRI measurements to cognitive function. RESULTS: We evaluated 23 patients and 17 controls. The MAP-MRI parameter 'return to the plane probability' (RTPP) had the strongest effect size (d = -1.678, lateralization ratio = 86.36 %) for differentiating hippocampus ipsilateral to the epileptogenic focus from contralateral hippocampus when compared to all other DTI/MAP-MRI parameters, signal intensity on FLAIR and hippocampal volumes. Mean diffusivity (MD), radial diffusivity (RD), mean square displacement (MSD) were each negatively correlated to clinical measures of delayed recall (r = -0.758; r = -0.772; r = -0.684, respectively). While return to the axis probability (RTAP) return to the origin probability (RTOP) and fractional anisotropy (FA) were positively correlated (r = 0.832; r = 0.813; r = 0.717, respectively) (all P < 0.05). CONCLUSION: MAP-MRI measurements are promising radiologic biomarkers for the non-invasive lateralization of epileptogenic foci in TLE.
PURPOSE: To compare MRI volume measurements, FLAIR image intensity, Diffusion tensor imaging (DTI) and mean apparent propagator (MAP)-MRI measurements in hippocampus ipsilateral and contralateral to the epileptogenic focus for non-invasive lateralization of temporal lobe epilepsy (TLE) and also compare these DTI and MAP-MRI measurements to cognitive function. METHOD: A cohort of patients with unilateral TLE and aged-and gendered-matched controls were enrolled in this retrospective study. T1-weighted MPRAGE data for the volume, FLAIR image intensity, DTI and MAP-MRI parameters were performed for bilateral hippocampi of all subjects. The sensitivity, specificity, lateralization ratios and Cohen's d effect sizes of all MR measurements were calculated. Pearson correlation analysis was performed to compare DTI and MAP-MRI measurements to cognitive function. RESULTS: We evaluated 23 patients and 17 controls. The MAP-MRI parameter 'return to the plane probability' (RTPP) had the strongest effect size (d = -1.678, lateralization ratio = 86.36 %) for differentiating hippocampus ipsilateral to the epileptogenic focus from contralateral hippocampus when compared to all other DTI/MAP-MRI parameters, signal intensity on FLAIR and hippocampal volumes. Mean diffusivity (MD), radial diffusivity (RD), mean square displacement (MSD) were each negatively correlated to clinical measures of delayed recall (r = -0.758; r = -0.772; r = -0.684, respectively). While return to the axis probability (RTAP) return to the origin probability (RTOP) and fractional anisotropy (FA) were positively correlated (r = 0.832; r = 0.813; r = 0.717, respectively) (all P < 0.05). CONCLUSION: MAP-MRI measurements are promising radiologic biomarkers for the non-invasive lateralization of epileptogenic foci in TLE.
Authors: Kadharbatcha S Saleem; Alexandru V Avram; Daniel Glen; Cecil Chern-Chyi Yen; Frank Q Ye; Michal Komlosh; Peter J Basser Journal: Neuroimage Date: 2021-11-25 Impact factor: 6.556