Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.
AJNR Am J Neuroradiol. 2011 Nov-Dec;32(10):1789-94. doi: 10.3174/ajnr.A2801. Epub 2011 Oct 13.
Patients with MR imaging-negative epilepsy could have subtle FCD. Our aim was to determine if structural changes could be identified by using DTI in children with intractable epilepsy, from MR imaging-visible FCD and MR imaging-negative localization-related epilepsy, that were concordant with the epileptogenic zone as defined by using the MEG dipole cluster.
Eight children with MR imaging-visible FCD and 16 with MR imaging-negative epilepsy underwent DTI and MEG. Twenty-six age-matched healthy children underwent DTI. Analysis was performed on controls across individual patients. Agreement between the location of DTI abnormalities and FCD and MEG dipole clusters was assessed.
In patients with MR imaging-visible FCD, abnormal FA, MD, λ(1), λ(2), and λ(3) were lobar concordant with the MEG dipole cluster in 4/8 (50.0%), 5/8 (62.5%), 3/8 (37.5%), 6/8 (75.0%), and 5/8 (62.5%), respectively. In patients with MR imaging-visible FCD, abnormal FA, MD, λ(1), λ(2), and λ(3) overlapped the x-, y-, and z-axes of the MEG dipole cluster in 1/8 (12.5%), 4/8 (50%), 4/8 (50%), 6/8 (75%), and 4/8 (50%), respectively, and with FCD in 1/8 (12.5%), 3/8 (37.5%), 0/8 (0%), 3/8 (37.5%), and 1/8 (12.5%), respectively. In patients with MR imaging-negative epilepsy, abnormal FA, MD, λ(1), λ(2), and λ(3) were lobar-concordant with the MEG dipole cluster in 11/16 (68.8%), 11/16 (68.8%), 8/16 (50.0%), 10/16 (62.5%), and 10/16 (62.5%), respectively, and overlapped the x-, y-, and z-axes of the MEG dipole cluster in 9/16 (56.3%), 10/16 (62.5%), 8/16 (50%), 8/16 (50%), and 8/16 (50%), respectively. There was no significant difference between abnormal DTI lobar concordance with the MEG dipole cluster in patients with MR imaging-visible FCD and MR imaging-negative epilepsy.
White matter changes can be detected with DTI in children with MR imaging-visible FCD and MR imaging-negative epilepsy, which were concordant with the epileptogenic zone in more than half of the patients.
磁共振成像阴性癫痫患者可能存在细微的功能性皮质发育不良。我们的目的是确定在磁共振成像可见局灶性皮质发育不良和磁共振成像阴性定位相关癫痫患者中，弥散张量成像（DTI）是否可以识别结构性变化，这些变化与使用MEG 偶极子群定义的致痫区一致。
8 例磁共振成像可见局灶性皮质发育不良患者和 16 例磁共振成像阴性癫痫患者接受了 DTI 和 MEG 检查。26 名年龄匹配的健康儿童接受了 DTI 检查。对每位患者的对照组进行了分析。评估了 DTI 异常与局灶性皮质发育不良和 MEG 偶极子群的位置之间的一致性。
在磁共振成像可见局灶性皮质发育不良患者中，4/8（50.0%）、5/8（62.5%）、3/8（37.5%）、6/8（75.0%）和 5/8（62.5%）患者的 FA、MD、λ(1)、λ(2)和 λ(3)异常呈脑叶一致性，与 MEG 偶极子群一致。在磁共振成像可见局灶性皮质发育不良患者中，1/8（12.5%）、4/8（50%）、4/8（50%）、6/8（75%）和 4/8（50%）患者的 FA、MD、λ(1)、λ(2)和 λ(3)异常与 MEG 偶极子群的 x、y 和 z 轴重叠，分别有 1/8（12.5%）、3/8（37.5%）、0/8（0%）、3/8（37.5%）和 1/8（12.5%）患者的 FA、MD、λ(1)、λ(2)和 λ(3)异常与局灶性皮质发育不良重叠。在磁共振成像阴性癫痫患者中，11/16（68.8%）、11/16（68.8%）、8/16（50.0%）、10/16（62.5%）和 10/16（62.5%）患者的 FA、MD、λ(1)、λ(2)和 λ(3)异常呈脑叶一致性，与 MEG 偶极子群一致，9/16（56.3%）、10/16（62.5%）、8/16（50%）、8/16（50%）和 8/16（50%）患者的 FA、MD、λ(1)、λ(2)和 λ(3)异常与 MEG 偶极子群的 x、y 和 z 轴重叠。磁共振成像可见局灶性皮质发育不良和磁共振成像阴性癫痫患者中，DTI 异常与 MEG 偶极子群的脑叶一致性无显著差异。
在磁共振成像可见局灶性皮质发育不良和磁共振成像阴性癫痫患者中，DTI 可检测到白质变化，与致痫区一致的患者超过一半。
