Quantitative Study Of White Matter In Patients With Routine Magnetic Resonance-negative Epilepsy By Diffusion Kurtosis Imaging

Purpose The symmetry of diffuse information in the mirror image of the right and left sides of the normal person was compared and analyzed using the diffusion kurtosis imaging quantitative parameters,and the diagnostic value of diffusion kurtosis imaging quantitative parameters in conventional magnetic resonance negative epilepsy was explored.Methods We prospectively collected 28 cases of idiopathic epilepsy diagnosed as negative by conventional magnetic resonance imaging and matched the information of age,sex,and hand with 34 normal subjects as control study.Magnetic resonance DKI sequence examination was performed in both groups.The obtained two sets of DKI sequence images were post-processed by relevant software to obtain FA,MD,MK,RK,AK parameter maps.In each parameter map,the white matter regions of the brain were circled symmetrically by 10 sets of regions of interest(ROI).Including the frontal lobe,temporal lobe,occipital lobe,parietal lobe,splenium of the corpus callosum,the genu of the corpus callosum,internal capsule forelimb,internal capsule posterior limb,external capsule,and hippocampal body part.Compare the differences in the values of the parameters of the symmetric brain regions on both sides of the normal group,and the differences in the DKI sequences of the same anatomical sites between the case group and the control group.Results FA parameters were compared between the normal group and the epilepsy group: bilateral frontal lobes(left side P=0.013,right side P=0.017),bilateral temporal lobes(left side P=0.013,right side P<0.001),and right occipital lobe(P=0.026).genu of corpus callosum(P=0.049),bilateral hippocampal body(left side P=0.034,right side P=0.003)and right side of external capsule(P=0.005)were significantly different,and The FA value of the normal group was higher than that of the epilepsy group.MK parameters were significantly different between the bilateral frontal lobes(left side P=0.013,right side P=0.029)and the bilateral external capsules(P=0.012 on the left,P=0.001 on the right),and the MK values in the normal group were higher than those in the epilepsy.The MD parameters were significantly different in the right frontal lobe(P=0.003),and the epilepsy group had a higher MD value than the normal group.Areas with significant differences in RK parameters were distributed in the bilateral frontal lobes(right P = 0.026,left P = 0.035),left parietal lobe(P = 0.007),left internal capsule forelimb(P = 0.005),right external capsule(P=0.028),and the normal group parameters were significantly larger than the epilepsy group.The AK parameters did not show significant statistical differences in all areas.No increase in MK,AK,and RK was found in all brain regions of the epilepsy group.The values of MD,MK,and AK in the symmetric brain regions of the normal group showed no significant difference in each region,and there was a significant difference in FA values between the normal and bilateral temporal lobe regions(P=0.004).The RK value was also significantly different between the bilateral temporal lobes(P=0.044).Conclusion There may be differences in the DKI parameters of multiple brain regions in the left and right symmetric parts of a normal person.Quantitative analysis of DKI sequence in comparison with normal people can detect and evaluate the white matter microstructural abnormalities in multiple brain regions of epilepsy patients.The abnormality of these white matter micro-structures may suggest the coexistence of multiple pathological changes,demonstrating the potential of DKI sequence to detect white matter abnormalities in patients with negative conventional magnetic resonance epilepsy.