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Abstract This study was performed to assess the role of diffusion tensor imaging in the detection of abnormality especially in patients with normal conventional MR through its ability to identify diffusion changes in the temporal lobe. We used tractography technique to assess the effect of epilepsy on the cerebral white matter.Forty patients clinically diagnosed as having temporal lobe epilepsy and twenty controls are included in our study. Conventional MRI and DTI were acquired in all of the studied population. EEG was carried out for 40 patients.FA was measured at the both temporal lobes in both patients and controls groups. MR tractography of the arcuate fasciculus, IFOF, ILF,uncinate fasciculus was done in all of studied population. We assessed these tracts as regard their FA, color hue, and integrity.We classified our patients according to the FA difference between both temporal lobes compared to value made by the mean FA differences in the control group into DTI positive patients of temporal lobe abnormality and DTI negative patients.Site of abnormality detected by DTI was compared with site of seizure focus in EEG in patients with focal EEG findings.Studying the association between degree of FA reduction and some clinical factors which were (age at onset of seizure, disease duration and seizure frequency) was carried out We found that DTI detected abnormality in patients with normal conventional MR. The correlation between DTI and EEG revealed that DTI results match with 90% of the focal EEG results..We found that the degree of FA reduction was positively correlated with the duration of the disease and seizure frequency and negatively correlated with age at onset of epilepsy. Only the correlation between FA reduction and the disease duration was statistically significant The pattern of affection of the mentioned tracts above in the form of reduction of their FA, displacement and their disruption in some patients.In conclusion, DTI can help in the detection of site of abnormality especially in patients with no gross abnormality in MRI and through tractography technique; it has a role in detecting the pattern of affection of the cerebral white matter in temporal lobe epilepsy patients. |