Whole-Brain Histogram and Voxel-Based Analyses of Apparent Diffusion Coefficient and Magnetization Transfer Ratio in Celiac Disease, Epilepsy, and Cerebral Calcifications Syndrome
R. Della Navea,
A. Magauddad,
R. Micheluccie,
G. Capizzif,
A. Calabròb,
L. Guerrinia,
C. Gavazzia,
S. Diciottic,
P. Riguzzie,
O. Danieleg,
N. Villaria,
C.A. Tassinarie and
M. Mascalchia
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
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Fig 1. Examples of visual rating of the extent of occipital calcifications on CT (A, C, E, and G) and corresponding T2*-weighted gradient-echo images without MT pulse (B, D, F, and H) in patients with CEC: minimal (score = 1) (A and B), mild (score = 2) (C and D), moderate (score = 3) (E and F), and severe (score = 4) (G and H). Only moderate and severe calcifications are appreciable as areas of low signal intensity in T2*-weighted images.
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Fig 2. Averaged whole-brain ADC histograms in the 3 groups of subjects. Patients with CEC and patients with CD show a rightward shift of the ADC values, implying increase of the median ADC value. In addition in patients with CEC and patients with CD, the histogram peak is less sharp, implying a reduced kurtosis, and the curve asymmetry is less pronounced, implying a reduced skewness.
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Fig 3. SPM2 results showing areas of decreased MTR in patients with CEC versus healthy control subjects (A) and versus patients with CD (B) superimposed on anatomic references. In patients with CEC, areas of significantly (PFDRcorr<0.05) decreased MTR compared with control subjects (A) include the white matter of the parietal lobe bilaterally (see Table 3; unthresholded statistical map is provided as supplemental Fig 2). Compared with patients with CD (B), the patients with CEC show areas of decreased MTR (Puncorr < 0.001) in the white matter of the left temporal lobe and right parietal lobe (see Table 3).
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