American Journal of Neuroradiology 28:479-485, March 2007
© 2007 American Society of Neuroradiology
BRAIN
Whole-Brain Histogram and Voxel-Based Analyses of Apparent Diffusion Coefficient and Magnetization Transfer Ratio in Celiac Disease, Epilepsy, and Cerebral Calcifications Syndrome
a Section of Radiodiagnostics, University of Florence, Florence, Italy
b Section of Gastroenterology, University of Florence, Florence, Italy
c Department of Clinical Physiopathology and Department of Electronics and Telecommunications, University of Florence, Florence, Italy
d Department of Neurology, University of Messina, Messina, Italy
e Division of Neurology, Bellaria Hospital, University of Bologna, Bologna, Italy
f Department of Child Neurology and Psychiatry, University of Turin, Turin, Italy
g Institute of Neuropsychiatry, University of Palermo, Palermo, Italy
Address correspondence to Prof. M. Mascalchi, Radiodiagnostic Section, Department of Clinical Physiopathology, University of Florence, Viale Morgagni 85, 50134 Florence, Italy; e-mail: m.mascalchi{at}dfc.unifi.it
BACKGROUND AND PURPOSE: 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.
MATERIALS AND 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.
CONCLUSION: 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.
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