Preliminary Study Of Diffusion Kurtosis Imaging In Children And Adolescents Primary Epilepsy

Objective: To study the cerebral changes of the children and adolescents primary epilepsy using diffusion kurtosis imaging(DKI), assessing the value of DKI in pathophysiologic mechanism study of children and adolescents epilepsy, as well as correlation with Intelligence Quotient(IQ).Materials and Methods: 34 patients from affiliated hospital of Zunyi Medical College, taken part in this study from March 1st, 2014 to January 31 th, 2015, All patients were screened by senior pediatric and neurological doctors in light of the 2005 International League against Epilepsy standard on diagnosing epilepsy and epilepsy syndrome. Of 34 patients, Male was 19 cases and Female 15 cases. Twenty healthy volunteers were recruited for normal control group( male 10 cases, female 10 cases). The study was approved by Zunyi Medical College Ethics Committee. All subjects were scanned with GE 3. 0T HDxt MRI scanner. The scanning sequence included T1 WI, T2-FLAIR and DKI sequence 。 Image Processing: MR image processing software package(FSL) was used to eddy current correction for diffusion images, DKE software was estimated DKI parameters. Then, the format conversion of the original images, original point resetting, image registration, spatial normalization and smoothing were performed using Statistical parametric mapping(SPM8)software.The two sample t-test was used to analyzing the fraction anisotropy(FA), mean diffusion(MD), mean kurtosis(MK) between the patients and the normal control group, the statistical threshold was set at p<0.005. xjview was used to draw the difference regions, the anatomical position was located according to MNI brain coordinate system and Broadmann partition. The slice viewer of Rest was used to display the abnormal difference regions, draw these regions as mask. The correlation analysis was performed between FA, MD, MK of patients and full scale intelligence quotient. P<0.05 was considered statistically significant difference.Results: No statistical difference was shown of sex, age and education level between the patient group and the comparison group. In bilateral abnomal group of EEG, FA decreased in the bilateral corpus callosum, the bilateral insula, the right middle frontal gyrus, the left precentral gyrus, the right cingulate gyrus, the right superior temporal gyrus, the left middle temporal gyrus, and the left thalamus. MD increased in the left frontal lobe, the right parietal lobe, the right cingulate gyrus, the left precentral gyrus, the postcentral gyrus, the left middle temporal gyrus, the left inferior parietal lobule and the cerebellar hemisphere. MK reduced in the right frontal lobe, the temporal lobe, and the left parietal lobe,the brain stem and the cerebellum. In unilateral abnomal group of EEG, FA reduced in the bilateral frontal lobe, temporal lobe, and parietal white matter, bilateral callosum and right insula. MD decreased in the bilateral insulas, the right frontal lobe and temporal lobe, the left occipital lobe and the left cerebellum. MK reduced in the right frontal lobe, temporal lobe, parietal lobe, insula, left temporo-parietal lobe, and the right brainstem. FA and MK are positively correlated with IQ, while MD negatively correlated with IQ.Conclusion: DKI could detect the extensively cerebral microstructural abnomalies that these abnormalties was correlation with IQ of patients with children and adolescents primary epilepsy who are negative on conventional MRI, thus providing a new perspective for physiologic mechanism study.