Diffusion Kurtosis Imaging In The Preliminary Study Of Patients With Temporal Lobe Epilepsy

Objective:The study was to explore the diagnostic significance of Diffusion Kurtosis Imaging (DKI) in evaluating the localizing the seizure side of epileptogenic focus by measuring mean kurtosis in hippocampus formation and white matter in anterior temporal lobe between temporal lobe epilepsy (TLE) group and control group. The MK value of temporal was analysised while revealed and assessed the secondary changes of brain.Materials and Methods:18TLE patients (10male,8female, age18-31year, average22.89±4.68year)(TLE group) and18volunteers (control group) were enrolled with similar subject characteristics (gender and age) for conventional axial conventional MRI, axial diffusion kurtosis imaging (DKI). The MK value and ADC value of following structions include bilateral hippocampus, caudate head(HCN), thalamus, anterior limb of the internal capsule(ALIC), frontal white matter(fWM), temporal white matter(tWM), parietal white matter (pWM) and the splenium of corpus callosum(SCC)were made statistical analysis. correlation analysis was investigated on MK value of duration and ipsilateral hippocampus of TLE group,whill the MK value and ADC value of both groups were analyzed by ROC curve.Results:MK values in bilateral ROI have no statistical significance for all volunteers (P>0.05), with descending order:SCC,PLIC, GCC,pWM,tWM, ALIC, thalamus, hippocampus, head of audate nucleus (HCN). MK values of hippocampus,HCN and pWM in ipsilateral brain were inferior to contralated(p<0.05); The MK values in ipsilateral ROI of the TLE group were inferior to the control group (p<0.05), and MK value in ipsilateral was significantly negatively correlated to the diease course. The MK value of ipsilateral ROI which included ALIC,PLIC,tWM,pWM were lower than control group (P<0.05) with no statistical significance in HCN, hippocampus, tWM. The SCC and GCC in TLE group were lower than control group (p<0.05). The area under the ROC curve and diagnostic threshold of MK value in ipsilateral hippocampus is0.877and0.666(sensitivity83.3%, specificity77.8%), with0.819and0.84×10-3mm2/s of ADC value (sensitivity77.8%, specificity88.9%)Conclusion:1The MK value of DKI may reflect the complexity of brain tissue.the complex, the higher.2The hippocampus and extra temporal structure of the brain in TLE group have obviousdifference in anatomical structure to contralateral,MK value of bilateral structures areinferior to the control group.The difference are significantly with negatively correlated tothe diease course. The MK value of temporal was analysised while revealed and assessedthe secondary changes of brain.3DKI are more advantage than tranditional DWI with better significance on localizationand lateralization when MK value of hippocampus is lower than0.666,which will bevaluable for the localizing the seizure side of epileptogenic focus in clinical.