Analysis of white matter volume of the temporal lobe in mesial temporal lobe epilepsy with hippocampal sclerosis based on automatic brain segmentation technique and its application value
Objective:To analyze the changes in white matter volume of the temporal lobe subre-gions in patients with medial temporal lobe epilepsy with hippocampal sclerosis(MTLE-HS)by auto-matic brain segmentation technique(FreeSurfer)and to investigate its clinical application value in MTLE-HS.Methods:A total of 53 patients diagnosed with MTLE-HS through postoperative pathology or magnetic resonance imaging(MRI)from January 2021 to September 2023 were collected,including 30 patients with left MTLE-HS(LMTLE-HS)and 23 patients with right MTLE-HS(RMTLE-HS).Meanwhile,43 gender-and age-matched healthy controls were recruited.All participants underwent T1-weighted three-dimensional magnetization-prepared rapid acquisition gradient echo sequence(3D-T1 WI-MPRAGE)scanning on a 3.0T MR.The FreeSurfer software was used to perform whole-brain segmentation on the T1-MPRAGE images,and white matter volume data of the temporal lobe subre-gions(posterior superior temporal gyrus,temporal pole,superior temporal gyrus,middle temporal gy-rus,inferior temporal gyrus,fusiform gyrus and parahippocampal gyrus)were collected.Paired t-tests were used to compare the differences in white matter volumes of each subregion between the left and right temporal lobes in the control group.Independent samples t-tests were used to compare the differ-ences in white matter volumes of each temporal lobe subregion between the control group and the LM-TLE-HS and RMTLE-HS groups,as well as between the affected and unaffected sides within the LM-TLE-HS and RMTLE-HS groups.Results:There were statistically significant differences in white mat-ter volumes of the transverse temporal gyrus,superior temporal gyrus,middle temporal gyrus,inferior temporal gyrus,fusiform gyrus and parahippocampal gyrus between the left and right sides in the con-trol group(P＜0.05).Significant differences in white matter volumes were found in the affected side of the LMTLE-HS group compared to the left side of the control group(temporal pole,transverse temporal gyrus,superior temporal gyrus,middle temporal gyrus,inferior temporal gyrus,fusiform gy-rus and parahippocampal gyrus)(P＜0.05).Significant differences in white matter volumes were found in the unaffected side of the LMTLE-HS group(posterior superior temporal gyrus,superior temporal gyrus,middle temporal gyrus,inferior temporal gyrus,fusiform gyrus and parahippocampal gyrus)and in the affected side of the RMTLE-HS group(posterior superior temporal gyrus,middle temporal gyrus,inferior temporal gyrus,fusiform gyrus and parahippocampal gyrus)compared to the right side of the control groups(P＜0.05).There were no statistically significant differences in volume among the other subregions(P＞0.05).Conclusion:The quantitative analysis of temporal lobe white matter volume using the automatic brain segmentation technique is of certain significance for preoper-ative evaluation and surgical approach selection in patients with hippocampal sclerotic medial temporal lobe epilepsy.
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