A diffusional kurtosis imaging study of idiopathic generalized epilepsy with unilateral interictal epileptiform discharges in children.
OBJECTIVE
To investigate brain abnormalities in children with a clinical diagnosis of idiopathic generalized epilepsy (IGE) and unilateral interictal epileptiform discharges (IED) demonstrated on electroencephalography (EEG) by diffusional kurtosis imaging (DKI).


METHODS
DKI images were obtained from 18 patients (n=9 each in the left and right hemispheres). Fractional anisotropy (FA), mean diffusivity (MD), and mean kurtosis (MK) maps were estimated through voxel-based analyses, and compared with 18 normal controls matched for age and sex.


RESULTS
In the left side group, the significant differences of FA were in the left fusiform gyrus and occipital lobe of the white matter (WM). The significant differences of MD were in the left pons. The significant differences of MK were in the anterior cingulate gyrus, limbic lobe, gray matter (GM) and WM of the right cerebrum. In the right side group, the significant differences of FA were in the WM of the left cerebrum. MD identified differences in the frontal, temporal, occipital, and parietal lobes of both hemispheres, especially in the limbic system, fusiform gyrus, uncus, and parahippocampal gyrus. The significant differences of MK were in the GM of the right cerebrum, particularly in the rolandic operculum and frontal lobe.


CONCLUSIONS
DKI is sensitive for the detection of diffusion abnormalities in both WM and GM of IGE in children. Secondary brain abnormalities may exist in regions outside the unilateral epileptogenic zone through the limbic epileptic network, and can be detected by DKI indices FA, MD and MK.
Department of Radiology, Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 200092 Shanghai, P.R. China. Electronic address: zhangyuzhen7@hotmail.com.
Yuzhen
Y
Zhang
Department of Radiology, Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 200092 Shanghai, P.R. China. Electronic address: gaoandyu@hotmail.com.
Yu
Y
Gao
Shanghai University of Medicine & Health Sciences, 201318 Shanghai, P.R. China. Electronic address: zhoumin_ecnu@163.com.
Minxiong
M
Zhou
Department of Pediatrics, Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 200092 Shanghai, P.R. China. Electronic address: wujie_xhyy@hotmail.com.
Jie
J
Wu
Department of Radiology, Keck School of Medicine, University of Southern California, California, United States. Electronic address: chishing@usc.edu.
Chishing
C
Zee
Department of Radiology, Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 200092 Shanghai, P.R. China. Electronic address: dbwang8@aliyun.com.
Dengbin
D
Wang
D016880:Anisotropy; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D004829:Epilepsy, Generalized / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008297:Male; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology
Children; Diffusional kurtosis imaging; Epilepsy; Magnetic resonance imaging; Unilateral