Goradia Dhruman, Chugani Harry T, Govindan Rajkumar Munian, Behen Michael, Juhász Csaba, Sood Sandeep
Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan, USA.
J Child Neurol. 2011 Oct;26(10):1246-51. doi: 10.1177/0883073811402689. Epub 2011 May 6.
The authors evaluated postsurgical reorganization of the arcuate fasciculus longitudinally using diffusion tensor imaging in 10 children with intractable epilepsy, whose resections included the left arcuate fasciculus. Evaluation of fractional anisotropy before and after surgery (mean follow-up: 7.5 months) showed a significant increase (P = .002) in the right arcuate fasciculus during follow-up. There was marked enlargement of the right arcuate fasciculus postsurgically in 8 patients. The change in right arcuate fasciculus fractional anisotropy values showed a positive correlation with interval between resection and postsurgical magnetic resonance imaging (MRI) (P = .044). Comparison of 10 age-matched controls to patients pre- and postsurgery showed significantly reduced presurgery fractional anisotropy in the left (P = .018) and right (P = .036) arcuate fasciculus and no difference in postsurgery fractional anisotropy in the right arcuate fasciculus (P = .399) in patients. These findings suggest a compensatory reorganization in the right arcuate fasciculus in children with intractable epilepsy following left arcuate fasciculus resection.
作者使用扩散张量成像对10例难治性癫痫患儿的弓状束术后重组进行了纵向评估，这些患儿的切除术包括左侧弓状束。对手术前后（平均随访7.5个月）的分数各向异性进行评估，结果显示随访期间右侧弓状束显著增加（P = .002）。8例患者术后右侧弓状束明显增粗。右侧弓状束分数各向异性值的变化与切除术后至术后磁共振成像（MRI）的间隔呈正相关（P = .044）。将10例年龄匹配的对照与患者手术前后进行比较，结果显示患者术前左侧（P = .018）和右侧（P = .036）弓状束的分数各向异性显著降低，而术后右侧弓状束的分数各向异性无差异（P = .399）。这些发现表明，难治性癫痫患儿在左侧弓状束切除后，右侧弓状束会发生代偿性重组。
