Diffusion tensor imaging in patients with epilepsy and malformations of cortical development
Diffusion tensor imaging in patients with epilepsy and malformations of cortical development
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DOI：
10.1093/brain/124.3.617
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发表时间：
2001-03-01
期刊：
影响因子：
14.5
通讯作者：
Duncan, JS
中科院分区：
文献类型：
--
作者：
Eriksson, SH;Rugg-Gunn, EJ;Duncan, JS
皮质发育畸形（MCD）是癫痫的常见原因。MCD患者的结构MRI和PET数据研究发现，肉眼识别的病变外存在广泛的变化。本研究的目的是研究MCD患者发作间期的弥散变化，并检验MCD与弥散广泛异常相关的假设。本文应用扩散张量成像（DTI）和统计参数图（SPM）对22例部分性发作合并MCD患者和30例正常对照者的脑组织结构进行了客观比较。采用回波平面成像获得全脑DTI，计算旋转不变各向异性和扩散率图，标准化到Talairach空间后，使用SPM将每个患者与对照组进行比较，在17例患者中发现各向异性降低的区域，在10例患者中发现扩散率增加的区域，2例患者的各向异性增加的区域，没有患者扩散率降低，扩散率增加的区域通常比各向异性降低的区域更广泛，在6例各向异性患者和9例扩散率患者中发现MCD以外的组织变化，在常规MRI上显示正常，两种测量均显示MCD以外的组织广泛变化，即向常规MRI添加信息，增加或异常定位的灰质或病理性白色物质与异常髓鞘形成或异位神经元可能导致各向异性降低，增加的扩散性可能由神经发生缺陷或细胞丢失导致细胞外空间增加引起。如果考虑手术治疗，应考虑到异常的广泛性。
Malformations of cortical development (MCD) are a common cause of epilepsy. Studies of structural MRIs and PET data in patients with MCD have found widespread changes outside the visually identified lesions. The aim of this study was to investigate diffusion changes interictally in patients with MCD and to test the hypothesis that MCD would be associated with widespread abnormalities of diffusion. We used diffusion tensor imaging (DTI) and statistical parametric mapping (SPM) to compare objectively tissue organization in 22 patients with partial seizures and MCD, with 30 control subjects. Whole-brain DTI was acquired using echo planar imaging, Rotationally invariant anisotropy and diffusivity maps were calculated and, after normalization to Talairach space, each patient was compared with the group of control subjects using SPM, Areas of reduced anisotropy were found in 17 patients and areas of increased diffusivity in 10, Two patients had areas of increased anisotropy, There were no patients with reduced diffusivity, Areas of increased diffusivity were in general more extensive than areas of reduced anisotropy, Changes in tissue beyond the MCD, that appeared normal on conventional MRI, were found in six patients for anisotropy and nine patients for diffusivity, Both measurements showed widespread changes in tissue beyond the MCD, i.e. adding information to conventional MRI, Increased or abnormally located grey matter or pathological white matter with abnormal myelination or ectopic neurones could cause reduced anisotropy, Increased diffusivity could be caused by a defect of neurogenesis or cell loss resulting in increased extracellular space. The widespread nature of abnormalities should be considered if surgical treatment is contemplated.