Diffusion tensor imaging analysis with tract-based spatial statistics of the XXXX after @entity302 surgery.

@entity1 @entity131 @entity410 @entity1315 @entity302 @entity6441 @entity1893 @entity62
INTRODUCTION: Diffusion tensor imaging (DTI) techniques demonstrated diffuse bilateral temporal and extra-temporal @entity62 in @entity1 presenting mesial @entity1315 with @entity131 ( @entity131 ). The aim of this study was to assess these diffusion changes following temporal lobe surgery, by applying a novel voxel-based tract-based spatial statistics (TBSS) technique for whole-brain analysis of fractional anisotropy (FA) and @entity1893 ( @entity1893 ). Second, region-of-interest analysis (ROI) was performed to improve statistical power. MATERIAL AND METHODS: The study included 22 @entity1 with unilateral @entity131 . Twelve @entity1 underwent temporal lobe surgery. Follow up MRI was done in a mean interval of 4 months. Voxelwise pre-operative FA asymmetry in all 22 @entity1 was assessed within subjects between lesional and contralateral hemispheres. The whole-brain post-operative dataset of 10 @entity410 -free @entity1 was compared with the corresponding pre-operative dataset using voxel-wise statistical analysis. Additionally, regional analysis at the fornices was done with skeleton-based region of interest (SROI). RESULTS: Within a mean interval time of 6.3 months after surgery, 10 of 12 @entity1 were @entity410 free (83.3%). The voxelwise comparison between lesional and contralateral hemispheres was consistent with previous studies showing a more widespread diffusion alteration in the lesional hemisphere. Voxel-wise comparison between post and pre-operative dataset did not show supra-thresholded voxels. SROI statistical analysis showed significant decrease in FA and increase in @entity1893 in the ipsilateral fornix. Significant increase in FA was observed in the contralateral fornix after surgery. CONCLUSION: The ipsi-lesional fornix showed decreased FA and increased @entity1893 after surgery, consistent with @entity6441 . In contrast, contra-lesional fornix demonstrated increase in FA. This observation is important for our understanding of the fate of the remaining brain tissue following removal of an @entity302 focus. Postoperative increase in FA may reflect structural reorganization in response to @entity302 surgery. The discrepancy between SROI and voxelwise statistics emphasizes the difference of statistical sensitivity between voxelwise and ROI analyses.
