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Research ArticlePediatric Neuroimaging

Hippocampal Alterations in Children with Temporal Lobe Epilepsy with or without a History of Febrile Convulsions: Evaluations with MR Volumetry and Proton MR Spectroscopy

Wen-Chau Wu, Chao-Ching Huang, Hsiao-Wen Chung, Michelle Liou, Chun-Jen Hsueh, Chang-Shin Lee, Ming-Long Wu and Cheng-Yu Chen
American Journal of Neuroradiology May 2005, 26 (5) 1270-1275;
Wen-Chau Wu
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Chao-Ching Huang
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Hsiao-Wen Chung
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Michelle Liou
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Chun-Jen Hsueh
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Chang-Shin Lee
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Ming-Long Wu
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Cheng-Yu Chen
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    Fig 1.

    Segmentation procedure. After manually tracing the in-plane boundaries, histogram-based segmentation was used to categorize the region of interest into CSF (black), gray matter (gray), and white matter (white). Only pixels of gray matter are counted to exclude the region of gliosis and atrophy.

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    Fig 2.

    For each subject, two sides of HV are divided into large and small sides. In the control group, the asymmetry index (AIv) is 2.2% on average. The plot shows different relationships among three groups in large and small sides. The interaction between groups and sides is statistically significant (P < .01).

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    Fig 3.

    For each subject, two sides of NAA/(Cho + Cr) ratios are divided into large and small sides. The asymmetry index (AIs) scatters in a wide range. In the control group, the AIs is 0.77 on the average. The plot shows that the relationships among three groups in large and small sides are quite parallel. There is a trend of lowering NAA/(Cho + Cr) ratios in TLE + FC, but no statistical interaction between groups and sides was found (P = .272).

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    TABLE 1:

    55 children were included for MR volumetry and MR spectroscopy study

    GroupsNumber (male/female)Age at MR imaging (yrs) mean ± std (range)
    Control16 (10/6)9.1 ± 3.6 (3–15)
    TLE + FC22 (12/10)8.8 ± 3.5 (3–15)
    TLE17 (6/11)8.2 ± 3.9 (1.5–14)
    • Note.—TLE indicates temporal lobe epilepsy; FC, febrile convulsion.

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    TABLE 2:

    Values of asymmetry indices in three groups

    ControlTLE + FCTLE
    AIv2.32 ± 1.58%9.22 ± 6.79%6.79 ± 5.73%
    AIs8.47 ± 5.08%18.10 ± 16.24%16.81 ± 10.02%
    • Note.—TLE indicates temporal lobe epilepsy; FC, febrile convulsion; AIv, volume asymmetry index; and AIs, spectroscopy asymmetry index. Both AIv and AIs are statistically smaller in Control than TLE + FC and TLE (P < .01 with AIv and P < .05 with AIs). No significant difference exists between TLE + FC and TLE either in AIv or AIs. As to conditions of normal hippocampal volume at both sides in epileptic groups, AIv culls 5/8 and 4/10 in TLE + FC and TLE, respectively. On the other hand, AIs picks out 1/6 and 1/4 of the subjects with bilaterally normal NAA/(Cho + Cr) in TLE + FC and TLE, respectively.

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American Journal of Neuroradiology: 26 (5)
American Journal of Neuroradiology
Vol. 26, Issue 5
1 May 2005
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Wen-Chau Wu, Chao-Ching Huang, Hsiao-Wen Chung, Michelle Liou, Chun-Jen Hsueh, Chang-Shin Lee, Ming-Long Wu, Cheng-Yu Chen
Hippocampal Alterations in Children with Temporal Lobe Epilepsy with or without a History of Febrile Convulsions: Evaluations with MR Volumetry and Proton MR Spectroscopy
American Journal of Neuroradiology May 2005, 26 (5) 1270-1275;

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Hippocampal Alterations in Children with Temporal Lobe Epilepsy with or without a History of Febrile Convulsions: Evaluations with MR Volumetry and Proton MR Spectroscopy
Wen-Chau Wu, Chao-Ching Huang, Hsiao-Wen Chung, Michelle Liou, Chun-Jen Hsueh, Chang-Shin Lee, Ming-Long Wu, Cheng-Yu Chen
American Journal of Neuroradiology May 2005, 26 (5) 1270-1275;
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