Using Voxel-based Morphometry And High-resolution MRI To Study Brain Structure Of Conventional Magnetic Resonance Negative Temporal Lobe Epilepsy

Purpose1.Using voxel-based morphometry to analyze the changes of brain gray matter volume in patients with conventional MRI negative temporal lobe epilepsy;2.Using high-resolution magnetic resonance oblique coronalT2-weighted imaging to analyze the change in the internal structure of hippocampus in patients with conventional MRInegative temporal lobe epilepsy.Materials and MethodWe selected 20 patients with conventional MRI-negative temporal lobe epilepsy and 18 patients with medial temporal lobe epilepsy associated with hippocampal sclerosis,and 25 normal persons with matching sex,age,and education level as control group.All subjects underwent sagittal T1WI-3D using a Siemens 3.0T Trio Tim magnetic resonance scanner.Whole brain gray matter volume was measured using the VBM based on T1WI-3D structural images to observe changes in brain gray matter volume.In addition,a high-resolution oblique coronal T2-weighted imaging was performed on all subjects using a Siemens 3.0T Skyra magnetic resonance scanner,and the internal structure of the hippocampus was analyzed.Results1.Compared with the normal control group,the volume of brain gray matter in the conventional MRI-negative temporal lobe epilepsy group and the medial temporal lobe epilepsy with hippocampal sclerosis group was extensively decreased;2.Compared with the normal control group,the volume of hippocampus in the conventional MRI-negative temporal lobe epilepsy group was not significantly different,and the brain regions with reduced gray matter volume included cerebellum,central posterior gyrus,insula,parahippocampal gyrus,putamen nucleus,cingulate gyrus,thalamus,caudate nucleus,precuneus and cingulate gyrus;3.Compared with the normal control group,the volume of hippocampuswas markedly declined inmedial temporal lobe epilepsy with hippocampal sclerosis group,and the gray matter volume of cerebellum,supraorbital gyrus,middle temporal gyrus,putamen nucleus,insula,thalamus,middle frontal gyrus,superior frontal gyrus,precuneus,postcentral gyrus and precentral gyrus was also decreased;4.Compared with conventional MRI-negative temporal lobe epilepsy group,the volume of hippocampus,parahippocampal gyrus,amygdala and putamen was markedly decreased in medial temporal lobe epilepsy with hippocampal sclerosis group;5.In conventional magnetic resonance imaging,hippocampal volume and signal in patients with mild hippocampal sclerosis in MRI-negative temporal lobe epilepsy were not abnormal,but in the high-resolution MRI oblique coronal T2-weighted imaging,the internal structure of the hippocampus was changed and the signal was interrupted.Conclusion1.Patients with MTLE+HS and MRI-negative TLE had diffuse cortical atrophy,indicating that long-term seizures can lead to decreased volume of brain gray matter in patients with epilepsy.2.There were similar brain regions of gray matter atrophy in patients with MRI-negative TLE and MTLE+HS,and the brain atrophy may share similar mechanisms.3.For MRI-negative TLE patients with mild hippocampal sclerosis,high-resolution MRI oblique coronal T2-weighted imaging can detect changes in the internal structure of the hippocampus,which has important clinical value for preoperative evaluation.