Abstract：
BACKGROUND: Abnormal levels of glutamate constitute a key pathophysiologic mechanism in epilepsy. The use of glutamate chemical exchange saturation transfer (GluCEST) imaging to measure glutamate levels in pediatric epilepsy is rarely reported in research.
OBJECTIVE: To investigate hippocampal glutamate level variations in pediatric epilepsy and the correlation between glutamate and hippocampal subregional volumes.
METHODS: Cross-sectional, prospective.
METHODS: A total of 38 school-aged pediatric epilepsy patients with structurally normal MRI as determined by at least two independent radiologists (60% males; 8.7 ± 2.5 years; including 20 cases of focal pediatric epilepsy [FE] and 18 cases of generalized pediatric epilepsy [GE]) and 17 healthy controls (HC) (41% males; 9.0 ± 2.5 years).
UNASSIGNED: 3.0 T; 3D magnetization prepared rapid gradient echo (MPRAGE) and 2D turbo spin echo GluCEST sequences.
RESULTS: The relative concentration of glutamate was calculated through pixel-wise magnetization transfer ratio asymmetry (MTRasym) analysis of the GluCEST data. Hippocampal subfield volumes were computed from MPRAGE data using FreeSurfer.
METHODS: This study used t tests, one-way analysis of variance, Kruskal-Wallis tests, and Pearson correlation analysis. P < 0.05 was considered statistically significant.
RESULTS: The MTRasym values of both the left and right hippocampi were significantly elevated in GE (left: 2.51 ± 0.23 [GE] vs. 2.31 ± 0.12 [HCs], right: 2.50 ± 0.22 [GE] vs. 2.27 ± 0.22 [HCs]). The MTRasym values of the ipsilateral hippocampus were significantly elevated in FE (2.49 ± 0.28 [ipsilateral] vs. 2.29 ± 0.16 [HCs]). The MTRasym values of the ipsilateral hippocampus were significantly increased compared to the contralateral hippocampus in FE (2.49 ± 0.28 [ipsilateral] vs. 2.35 ± 0.34 [contralateral]). No significant differences in hippocampal volume were found between different groups (left hippocampus, P = 0.87; right hippocampus, P = 0.87).
CONCLUSIONS: GluCEST imaging have potential for the noninvasive measurement of glutamate levels in the brains of children with epilepsy.
METHODS: 2 TECHNICAL EFFICACY: Stage 1.
OBJECTIVE: To investigate hippocampal glutamate level variations in pediatric epilepsy and the correlation between glutamate and hippocampal subregional volumes.
METHODS: Cross-sectional, prospective.
METHODS: A total of 38 school-aged pediatric epilepsy patients with structurally normal MRI as determined by at least two independent radiologists (60% males; 8.7 ± 2.5 years; including 20 cases of focal pediatric epilepsy [FE] and 18 cases of generalized pediatric epilepsy [GE]) and 17 healthy controls (HC) (41% males; 9.0 ± 2.5 years).
UNASSIGNED: 3.0 T; 3D magnetization prepared rapid gradient echo (MPRAGE) and 2D turbo spin echo GluCEST sequences.
RESULTS: The relative concentration of glutamate was calculated through pixel-wise magnetization transfer ratio asymmetry (MTRasym) analysis of the GluCEST data. Hippocampal subfield volumes were computed from MPRAGE data using FreeSurfer.
METHODS: This study used t tests, one-way analysis of variance, Kruskal-Wallis tests, and Pearson correlation analysis. P < 0.05 was considered statistically significant.
RESULTS: The MTRasym values of both the left and right hippocampi were significantly elevated in GE (left: 2.51 ± 0.23 [GE] vs. 2.31 ± 0.12 [HCs], right: 2.50 ± 0.22 [GE] vs. 2.27 ± 0.22 [HCs]). The MTRasym values of the ipsilateral hippocampus were significantly elevated in FE (2.49 ± 0.28 [ipsilateral] vs. 2.29 ± 0.16 [HCs]). The MTRasym values of the ipsilateral hippocampus were significantly increased compared to the contralateral hippocampus in FE (2.49 ± 0.28 [ipsilateral] vs. 2.35 ± 0.34 [contralateral]). No significant differences in hippocampal volume were found between different groups (left hippocampus, P = 0.87; right hippocampus, P = 0.87).
CONCLUSIONS: GluCEST imaging have potential for the noninvasive measurement of glutamate levels in the brains of children with epilepsy.
METHODS: 2 TECHNICAL EFFICACY: Stage 1.
摘要：
背景：谷氨酸水平异常是癫痫的关键病理生理机制。研究中很少报道使用谷氨酸化学交换饱和转移（GluCEST）成像来测量小儿癫痫中的谷氨酸水平。
目的：研究小儿癫痫海马谷氨酸水平的变化及其与海马次区域体积的相关性。
方法：横截面，前瞻性。
方法：共有38名学龄儿童癫痫患者，其MRI结构正常，至少由两名独立放射科医师确定（60％男性；8.7±2.5岁；包括20例局灶性小儿癫痫[FE]和18例全身性小儿癫痫[GE]）和17名健康对照（HC）（41％男性；9.0±2.5岁）。
■3.0T；3D磁化准备了快速梯度回波（MPRAGE）和2D涡轮自旋回波GluCEST序列。
结果：通过GluCEST数据的逐像素磁化转移比不对称性（MTRasym）分析来计算谷氨酸的相对浓度。使用FreeSurfer从MPRAGE数据计算海马子场体积。
方法：本研究采用t检验，单向方差分析，Kruskal-Wallis测试,和Pearson相关分析。P<0.05被认为具有统计学意义。
结果：在GE中，左右海马的MTRasym值均显着升高（左：2.51±0.23[GE]与2.31±0.12[HCs]，右：2.50±0.22[GE]vs.2.27±0.22[HCs])。FE中同侧海马的MTRasym值显着升高（2.49±0.28[同侧]vs.2.29±0.16[HCs])。FE中同侧海马的MTRasym值与对侧海马相比显着增加（2.49±0.28[同侧]vs.2.35±0.34[对侧])。不同组间海马体积无显著差异(左海马,P=0.87；右侧海马，P=0.87）。
结论：GluCEST成像具有非侵入性测量癫痫患儿大脑中谷氨酸水平的潜力。
方法：2技术效果：第一阶段。
目的：研究小儿癫痫海马谷氨酸水平的变化及其与海马次区域体积的相关性。
方法：横截面，前瞻性。
方法：共有38名学龄儿童癫痫患者，其MRI结构正常，至少由两名独立放射科医师确定（60％男性；8.7±2.5岁；包括20例局灶性小儿癫痫[FE]和18例全身性小儿癫痫[GE]）和17名健康对照（HC）（41％男性；9.0±2.5岁）。
■3.0T；3D磁化准备了快速梯度回波（MPRAGE）和2D涡轮自旋回波GluCEST序列。
结果：通过GluCEST数据的逐像素磁化转移比不对称性（MTRasym）分析来计算谷氨酸的相对浓度。使用FreeSurfer从MPRAGE数据计算海马子场体积。
方法：本研究采用t检验，单向方差分析，Kruskal-Wallis测试,和Pearson相关分析。P<0.05被认为具有统计学意义。
结果：在GE中，左右海马的MTRasym值均显着升高（左：2.51±0.23[GE]与2.31±0.12[HCs]，右：2.50±0.22[GE]vs.2.27±0.22[HCs])。FE中同侧海马的MTRasym值显着升高（2.49±0.28[同侧]vs.2.29±0.16[HCs])。FE中同侧海马的MTRasym值与对侧海马相比显着增加（2.49±0.28[同侧]vs.2.35±0.34[对侧])。不同组间海马体积无显著差异(左海马,P=0.87；右侧海马，P=0.87）。
结论：GluCEST成像具有非侵入性测量癫痫患儿大脑中谷氨酸水平的潜力。
方法：2技术效果：第一阶段。
