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DTI examination of child with epilepsy

Case Study
Dr. Lee, Seung-Koo, M.D. Seoul, Yonsei University College of Medicine Korea

Patient history:

A seven-year-old boy, who was involved in a vehicular accident three years before, was suffering from intractable seizure. Electroencephalography showed a persistent discharge of an epileptic wave in the right hemisphere. The pediatric neurosurgeon planned a functional right hemispherectomy for treatment of the intractable seizure. However, he showed right side hemiplegia instead of left side dysfunction.

MR examination:

The MR brain examination included diffusion weighted imaging and fiber tracking.

MR images and interpretation:

The T2-weighted images show cerebromalacia of the right hemisphere and atrophy.

Precentral gyrus is relatively spared.


These fractional anisotropy maps show a lack of high signal intensity of the longitudinal pontine fibers, in the left side cerebral peduncle, suggesting axonal injury.


 Click image to enlarge
Click image to enlarge


Fiber tractography shows cutting off of left corticospinal tract at the level of the left cerebral peduncle due to axonal injury (thick arrow). Right corticospinal tract is intact although atrophy and cerebromalacia are demonstrated in the remainder of the brain.


These DTI and fiber tracking findings helped to determine the patient's treatment. Callosotomy was performed instead of a functional hemispherectomy that would result in quadriplegia.



More information in the Clinical View article:

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Nov 26, 2005

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Case Study
Achieva 1.5T
Release 1
Nova, Nova Dual, Pulsar
Brain, Neuro

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