title: Whole-brain histogram and voxel-based analyses of apparent diffusion coefficient and magnetization transfer ratio in celiac disease, epilepsy, and cerebral calcifications syndrome.
abstract: OBJECTIVE
  Diffusion and magnetization transfer (MT) techniques have been applied to the investigation with MR of epilepsy and have revealed changes in patients with or without abnormalities on MR imaging. We hypothesized that also in the coeliac disease (CD), epilepsy and cerebral calcifications (CEC) syndrome diffusion and MT techniques could reveal brain abnormalities undetected by MR imaging and tentatively correlated to epilepsy.
  
  
  METHODS
  Diffusion and MT weighted images were obtained in 10 patients with CEC, 8 patients with CD without epilepsy and 17 healthy volunteers. The whole brain apparent diffusion coefficient (ADC) and MT ratio (MTR) maps were analyzed with histograms and the Statistical Parametric Mapping 2 (SPM2) software. We employed the non-parametric Mann-Whitney U test to assess differences for ADC and MTR histogram metrics. Voxel by voxel comparison of the ADC and MTR maps was performed with 2 tails t-test corrected for multiple comparison.
  
  
  RESULTS
  A significantly higher whole brain ADC value as compared to healthy controls was observed in CEC (P = 0.006) and CD (P = 0.01) patients. SPM2 showed bilateral areas of significantly decreased MTR in the parietal and temporal subcortical white matter (WM) in the CEC patients.
  
  
  CONCLUSIONS
  Our study indicates that diffusion and MT techniques are also capable of revealing abnormalities undetected by MR imaging. In particular patients with CEC syndrome show an increase of the whole brain ADC histogram which is more pronounced than in patients with gluten intolerance. IN CEC patients, voxel-based analysis demonstrates a localized decrease of the MTR in the parieto-temporal subcortical WM.
authors.affiliation: Section of Radiodiagnostics, University of Florence, Florence, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Della Nave
authors.forename: A
authors.initials: A
authors.lastname: Magaudda
authors.forename: R
authors.initials: R
authors.lastname: Michelucci
authors.forename: G
authors.initials: G
authors.lastname: Capizzi
authors.forename: A
authors.initials: A
authors.lastname: Calabrò
authors.forename: L
authors.initials: L
authors.lastname: Guerrini
authors.forename: C
authors.initials: C
authors.lastname: Gavazzi
authors.forename: S
authors.initials: S
authors.lastname: Diciotti
authors.forename: P
authors.initials: P
authors.lastname: Riguzzi
authors.forename: O
authors.initials: O
authors.lastname: Daniele
authors.forename: N
authors.initials: N
authors.lastname: Villari
authors.forename: C A
authors.initials: CA
authors.lastname: Tassinari
authors.forename: M
authors.initials: M
authors.lastname: Mascalchi
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D002114:Calcinosis / Q000473:pathology; D002446:Celiac Disease / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D004827:Epilepsy / Q000473:pathology*; D005260:Female; D005983:Glutens / Q000009:adverse effects; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male
chemical_list: D005983:Glutens