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Purpose: This study was conducted to assess the clinical relevance of diffusion tensor tractography (DTT) in pre- and post-operative evaluations of childhood epilepsy surgery. Materials and Methods: Seventy-two patients who received epilepsy surgery between March 2004 and July 2008 were retrospectively analyzed (M : F=40 : 32, ages of 3 months to 24 years, mean age=8.9 years). DTT was performed using a 3.0 T scanner and single-shot spin-echo echo-planar imaging with 32-different diffusion gradient directions. We reviewed the data focusing on the type of surgery, final pathological diagnosis, and how the DTT data were clinically used. Results: The most common form of childhood epilepsy surgery was complete resection of an epileptogenic lesion (n=52, 72.2%). The reported etiologies included cortical dysplasia (n=32, 44.4%), hippocampal sclerosis (n=9, 12.5%), brain tumors (n=7, 9.7%), and non-pathologic lesions (n=4, 5.6%) in the final diagnoses. Twenty-one dysplastic cortexes and four brain tumors involved an approximal relationship with the corticospinal tract (n=18), optic radiation (n=2), and arcuate fasciculus (n=5). Additionally, although DTT demonstrated white matter tracts clearly, DTT in the hippocampal sclerosis did not provide any additional information. In cases of callosotomy (n=18, 25%), post-operative DTT was utilized for the evaluation of complete resection in all patients. DTT information was not used in functional hemispherectomy (n=2, 2.8%). Conclusion: Preoperatively, DTT was a useful technique in cases of cortical dysplasia and brain tumors, and in cases with callosotomy, postoperatively. DTT should be included among the routine procedures performed in management of epilepsy.

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참고문헌 (20건) : 자료제공( 네이버학술정보 )

참고문헌 목록에 대한 테이블로 번호, 참고문헌, 국회도서관 소장유무로 구성되어 있습니다.
번호 참고문헌 국회도서관 소장유무
1 The prevalence and incidence of convulsive disorders in children. 네이버 미소장
2 Surgical treatment of medically refractory epilepsy in childhood 네이버 미소장
3 Neuroimaging in pediatric epilepsy: a multimodality approach. 네이버 미소장
4 Diffusion-based tractography in neurological disorders: concepts, applications, and future developments. 네이버 미소장
5 Diffusion-tensor MR imaging and fiber tractography: a new method of describing aberrant fiber connections in developmental CNS anomalies. 네이버 미소장
6 Malformations of cortical development: high-resolution MR and diffusion tensor imaging of fiber tracts at 3T. 네이버 미소장
7 Diffusion tensor tractography in patients with cerebral tumors: A helpful technique for neurosurgical planning and postoperative assessment 네이버 미소장
8 Three‐dimensional tracking of axonal projections in the brain by magnetic resonance imaging 네이버 미소장
9 Diffusion tensor imaging of the brain: review of clinical applications. 네이버 미소장
10 Epileptogenesis in pediatric cortical dysplasia: the dysmature cerebral developmental hypothesis. 네이버 미소장
11 Subcortical alterations in tissue microstructure adjacent to focal cortical dysplasia: detection at diffusion-tensor MR imaging by using magnetoencephalographic dipole cluster localization. 네이버 미소장
12 Outcome of epilepsy surgery in focal cortical dysplasia. 네이버 미소장
13 Seizure outcome after epilepsy surgery in children and adolescents 네이버 미소장
14 Raybaud C, Shroff M, Rutka JT, Chuang SH. Imaging surgical epilepsy in children. Childs Nerv Syst 2006;22:786-809. 미소장
15 Diffusion tensor MRI in temporal lobe epilepsy 네이버 미소장
16 White-matter diffusion abnormalities in temporal-lobe epilepsy with and without mesial temporal sclerosis. 네이버 미소장
17 Bilateral diffusion tensor abnormalities of temporal lobe and cingulate gyrus white matter in children with temporal lobe epilepsy 네이버 미소장
18 Defining Meyer's loop–temporal lobe resections, visual field deficits and diffusion tensor tractography 네이버 미소장
19 Clinical outcomes after corpus callosotomy in patients with bihemispheric malformations of cortical development. 네이버 미소장
20 Jea A, Vachhrajani S, Widjaja E, Nilsson D, Raybaud C, Shroff M, et al. Corpus callosotomy in children and the disconnection syndromes: a review. Childs Nerv Syst 2008;24:685-92. 미소장

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