Multi-Parameter MRI for Evaluating Glymphatic Impairment and White-Matter Abnormalities and Discriminating Refractory Epilepsy in Children

作者：Lu Qiu, Miaoyan Wang, Surui Liu, Bo Peng, Ying Hua, Jianbiao Wang, Xiaoyue Hu, Anqi Qiu, Yakang Dai, Haoxiang Jiang · 发表于：Korean Journal of Radiology · 年份：2025 · DOI：10.3348/kjr.2024.0718 · 被引用次数：3 · 研究领域：Cerebrospinal fluid and hydrocephalus、Epilepsy research and treatment、Spinal Dysraphism and Malformations

Objective: To explore glymphatic impairment in pediatric refractory epilepsy (RE) using multi-parameter magnetic resonance imaging (MRI), assess its relationship with white-matter (WM) abnormalities and clinical indicators, and preliminarily evaluate the performance of multi-parameter MRI in discriminating RE from drug-sensitive epilepsy (DSE). Materials and Methods:We retrospectively included 70 patients with DSE (mean age, 9.7 3.5 years; male:female, 37:33) and 26 patients with RE (9.0 2.9 years; male:female, 12:14).The diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index as well as fractional anisotropy (FA), mean diffusivity (MD), and nodal efficiency values were measured and compared between patients with RE and DSE.With sex and age as covariables, differences in the FA and MD values were analyzed using tract-based spatial statistics, and nodal efficiency was analyzed using a linear model.Pearson's partial correlation was analyzed.Receiver operating characteristic (ROC) curves were used to evaluate the discrimination performance of the MRI-based machine-learning models through five-fold cross-validation.Results: In the RE group, FA decreased and MD increased in comparison with the corresponding values in the DSE group, and these differences mainly involved the callosum, right and left corona radiata, inferior and superior longitudinal fasciculus, and posterior thalamic radiation (threshold-free cluster enhancement, P < 0.05).The RE group also s...