Structural MRI and tract-based spatial statistical analysis of diffusion tensor imaging in children with hemimegalencephaly
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Updated: Dec 15, 2025
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Tae Yeon Jeon1, Andrew V Poliakov2, Seth D Friedman2
1Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Republic of Korea. hathor97.jeon@samsung.com.
Purpose:
To investigate the gross white matter abnormalities in the structural brain MR imaging as well as white matter microstructural alterations using tract-based spatial statistics (TBSS) analysis of diffusion tensor imaging (DTI) in both affected and contralateral cerebral hemispheres of children with hemimegalencephaly (HMEG).
Methods:
From 2003 to 2019, we retrospectively reviewed brain MR images in 20 children (11 boys, 2 days-16.5 years) with HMEG, focusing on gross white matter abnormalities. DTI was evaluated in 12 patients (8 boys, 3 months-16.5 years) with HMEG and 12 age-, sex-, and magnetic field strength-matched control subjects. TBSS analysis was performed to analyze main white matter tracts. Regions of significant differences in fractional anisotropy (FA) were determined between HMEG and control subjects and between affected and contralateral hemispheres of HMEG.
Results:
Gross white matter abnormalities were noted in both affected (n = 20, 100%) and contralateral hemisphere (n = 4, 20%) of HMEG. FA values were significantly decreased in both hemispheres of HMEG, compared with control subjects (P < 0.05). Contralateral hemispheres of HMEG showed regions with significantly decreased FA values compared with affected hemispheres (P < 0.05).
Conclusions:
In addition to gross white matter abnormalities particularly evident in affected hemispheres, DTI analysis detected widespread microstructural alterations in both affected and contralateral hemispheres in HMEG suggesting HMEG may involve broader abnormalities in neuronal networks.
Insights
Hemimegalencephaly (HMEG) involves gross white matter abnormalities and widespread microstructural changes in both affected and unaffected brain hemispheres. Diffusion tensor imaging (DTI) reveals these alterations, suggesting broader network involvement in HMEG.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- White Matter Diseases
Background:
- Hemimegalencephaly (HMEG) is a rare congenital brain malformation.
- Understanding white matter abnormalities in HMEG is crucial for diagnosis and treatment.
- Structural and microstructural changes impact neurological function.
Purpose of the Study:
- To investigate gross white matter abnormalities using structural MRI in children with HMEG.
- To assess white matter microstructural alterations with diffusion tensor imaging (DTI) and tract-based spatial statistics (TBSS).
- To compare affected and contralateral hemispheres in HMEG patients and with controls.
Main Methods:
- Retrospective review of brain MR images from 20 children with HMEG (2 days-16.5 years).
- DTI analysis performed on 12 HMEG patients and 12 matched controls.
- TBSS analysis used to evaluate white matter tracts and fractional anisotropy (FA) differences.
Main Results:
- Gross white matter abnormalities observed in 100% of affected and 20% of contralateral hemispheres in HMEG.
- Significantly decreased FA values in both hemispheres of HMEG patients compared to controls (P < 0.05).
- Contralateral hemispheres in HMEG showed reduced FA compared to affected hemispheres (P < 0.05).
Conclusions:
- HMEG presents with significant gross and microstructural white matter abnormalities.
- DTI reveals widespread alterations in both affected and contralateral hemispheres, indicating broader network involvement.
- Findings suggest HMEG impacts neuronal networks beyond the visibly enlarged hemisphere.
