Magnetic Resonance Diffusion Tensor Imaging Study Of Whole Brain White Matter In Benign Childhood Epilepsy With Centrotemporal Spikes

Objective: epilepsy is a chronic brain disease caused by a variety of causes.Repeated and paroxysmal neuron abnormal discharge can lead to abnormal brain microstructure,which leads to the change of water molecule dispersion movement.Diffusion tensor imaging(DTI)is a novel approach based on diffusion weighted imaging(DWI),which takes account of the anisotropy of the diffusion motion of water molecules and quantifies them in many ways to reflect the minute structural and functional changes in living tissue.It has been widely used in the study of physiological and pathological changes of epilepsy and other central nervous system tissues.In this paper,we study the benign epilepsy in children with central temporal region spike wave(benign childhood epilepsy with centrotemporal spikes,BECT)is a common childhood epilepsy syndrome,has obvious age dependency,onset age of 3 ~ 13 years old,male is slightly larger,usually relieve before puberty,prognosis is good.The main clinical manifestations are short duration of movement or sensory seizures.Although benign,prolonged release may be associated with mild cognitive impairment.The locus of epileptic foci plays a decisive role in cognitive impairment,and the dominant hemisphere discharge is more likely to cause mild cognitive impairment.DTI has a wide range of applications in the study of epileptic-related networks,including localization of epileptic foci,location of major white matter pathways(such as visual radiation),and understanding of white matter lesions associated with different epilepsy syndromes.The purpose of this study was to analyze the structure of white matter in BECT children through DTI.With a relatively large sample size,the TBSS method was used to study the changes in the microstructure of white matter in BECTS children,and to further analyze whether the changes were significantly correlated with clinical indicators such as BECT convulsion frequency and cognition.Therefore,BECT pathophysiological mechanism can be further explored to provide more accurate and valuable imaging information for clinical use.Methods: 30 children(aged 3-15)with BECTS were included as the case group,and 30 children whose gender,age,gender,age and education level were matched with the case group as the control group.Conventional and DTI images were obtained using the Discovery MR750 3.0t magnetic resonance scanner produced by GE.MATLAB platform integrated FSL tool kit PANDA software line DTI data processing.First,the DICOM format data is converted to NIFTI format.The linear image registration method is used to register all the diffusion-weighted images to the standard image for motion correction.Unless the brain tissue component reduces the image size.Finally,DTI parameter values of each voxel in brain space of each subject were calculated using DTIFIT kit.White matter skeleton fibers were extracted and registered with the TBSS toolkit to obtain statistical analysis based on white matter fiber skeleton voxel levels.Finally,the non-parametric test of voxel level in the white matter skeleton space was carried out using the FSL software integrated with randomize function,so as to obtain the area with significant statistical difference between groups.Results: this study shows that differences between case group compared with normal control group FA small area to the right side of the clamp and the left front small pliers,corona radiata,but the average diffusion rate(Mean diffusivity,MD)in the right side of the internal capsule,external capsule,thalamus,the hind legs after radiation and corpus callosum body,pressure increased compared with normal control group,the left side of the corpus callosum body,pressure on the radial and longitudinal fasciculus increased compared with normal control group,and there are significant differences.Axial diffusivity(AD)in BECT group compared with normal control group.The areas of significant difference were right posterior radiating crown,corpus callosum ramus,corpus callosum corpora,left corpus callosum corpora,left corpus callosum ramus,and posterior radiating crown.Radial diffusion rate(Radial diffusivity,RD)in addition to the internal and external capsule,and no other parts of the abnormal dispersion.Based on the above results,it can be seen that the body part of the corpus callosum is the main part of the dispersion abnormality in the case group compared with the control group.The dispersion changes of MD and AD were the most significant.Conclusion: although BECT for benign epilepsy,but there are still abnormal microstructure,lead to extracellular broadening gap,resulting in DTI parameters FA,MD,the change of the AD,RD,DTI allow directly in the body to check some of the characteristics of the microstructure,DTI in neuroanatomy,fiber connection and abnormal tissue microstructure has important application value.DTI can find lesions that cannot be shown by conventional MRI,and it can better understand the pathophysiology of BECT patients and the structural abnormalities caused by epileptic discharge,which is helpful to judge the site of epileptic focus and further evaluate the degree of the disease caused by epileptic discharge.