Study Of The Changes Of White Matter In Children With Idiopathic Generaliased Epilepsy Using Diffusion Kurtosis Imaging

Objective:To study the white matter change in children with idiopathic generalized epilepsy using diffusion kurtosis imaging（tract-based spatial statistics）,explore the correlation between the changes with clinical variables（course of disease,verbal intelligence quotient,performance intelligence quotient,full intelligence quotient）.Methods:Twenty-four patients with idiopathic generalized epilepsy（10 males and 14females）who were negative on routine magnetic resonance imaging from pediatric outpatient and inpatient department of affiliated hospital of zunyi medical university between March 2016 with December 2018 were collected as case grozup.And 28 patients（14 males and 14 females）with similar general data as case group were collected as control group.Chi-square test was used for gender in case group and control group,and two-sample t-test was used for age and education level.The children in the case group were tested with the Chinese-Wechsler Children Intelligence Scale（CWIS）for 6-18 years old.All subjects underwent MRI scans according to the same protocol.Image acquisition was performed on a GE Signa HDxt 3.0T superconducting magnetic resonance scanner.The scanning sequence included T₁WI,T₂-FLAIR and DKI sequence.Image processing:First,dicom format is converted to nii format by using MRIcron for windows software,and then DKI image is batched with DKE software to obtain anisotropic fraction FA（fraction anisotropy）,mean diffusivity（MD）,mean kurtosis（MK）of all subjects.Then,the mean FA skeleton map（FA threshold is 0.2）was constructed based on FA data of all subjects by using FMRIB software library（FSL）.Finally,the Permutation test of n=5000 was used,p<0.05 was used as statistical difference,and JHUICBM-DTI-81 template was used to display the different brain regions.The relevant parameters were extracted in different regions by using FSL software.The correlation between the parameters and clinical variables（course of disease,verbal intelligence quotient,performance intelligence quotient,full intelligence quotient）was observed by Spearman correlation（p<0.05）.Results:There was no significant difference in sex,age and education level between the case group and the control group（p>0.05）.Compared with the control group,the decreased brain area of MK was corpus callosum（genu,body,splenium）,bilateral external capsule,bilateral anterior limb of internal capsule,bilateral posterior limb of internal capsule,bilateral anterior corona radiation,bilateral anterior radiation corona and bilateral posterior thalamus radiation;the decreased brain area of FA was corpus callosum（genu,body,splenium）,left external capsule,anterior limb of internal capsule,anterior corona radiation,posterior thalamic radiation and right external capsule,posterior limb of internal capsule and anterior radiation crown;the increased brain area of MD was located in the corpus callosum（genu,body,splenium）,right posterior limb of internal capsule and left external capsule.The correlation analysis showed that the course of disease had no significant correlation with VIQ,PIQ and FIQ,the average FA and MD values had no significant correlation with course of disease,VIQ,PIQ and FIQ,and the average MK value had no significant correlation with course of disease,VIQ and FIQ.The average MK value of the case group was positively correlated with PIQ(r_s=0.392,p<0.05).Conclusion:There are extensive abnormal white matter structure in children with idiopathic generalized epilepsy,and MK can find more abnormal brain areas.The DKI characteristic parameter MK can detect more extensive abnormal brain areas.Mean MK is correlated with performance intelligence quotient,which provides a new basis for revealing the pathophysiological mechanism of children with idiopathic generalized epilepsy.