Shraddha Sharma

Background: Conventional magnetic resonance imaging (MRI) may appear normal in a proportion of patients with temporal lobe epilepsy (TLE). Diffusion tensor imaging (DTI) provides quantitative measures of white matter microstructure and may reveal subtle changes not visible on routine MRI. This study compared DTI-derived diffusion metrics with standard MRI epilepsy protocols in patients with unilateral TLE to assess the extent and pattern of white matter alterations.Methods: A cross-sectional observational study was conducted in the Department of Radiodiagnosis at Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India, with all MRI and DTI studies performed on a GE Signa Pioneer 3.0T system (GE Healthcare, DV26.0 software) using a dedicated 32-channel head coil. Twenty-one patients with confirmed TLE and 11 age-matched controls underwent both conventional MRI and DTI. Regions of interest (ROIs) were placed on the hippocampus, fornix, thalamus, corpus callosum, internal capsule, cingulum, and inferior fronto-occipital fasciculus (IFO) tracts. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were analyzed using IBM SPSS Statistics version 26.Results: DTI revealed statistically significant alterations in FA and ADC values across multiple brain regions, including the hippocampus (FA: p < 0.05, ADC: p < 0.05), thalamus (FA: p << 0.001, ADC: p << 0.001), corpus callosum (FA: p << 0.001-0.05), internal capsule (FA: p << 0.001-0.05), and IFO tracts (FA and ADC: p << 0.001), demonstrating higher diagnostics compared to conventional MRI.Conclusions: This study highlights that DTI offers additional microstructural information beyond conventional MRI in unilateral TLE. DTI may therefore serve as a complementary imaging tool, particularly in cases where standard MRI appears normal. Further diagnostic accuracy studies are required before DTI can be considered a superior or standalone modality.

Background: Inflammatory bowel diseases (IBD), comprising Crohn’s disease (CD) and ulcerative colitis (UC), are chronic relapsing inflammatory disorders requiring accurate diagnosis and periodic monitoring. Cross-sectional imaging modalities such as magnetic resonance enterography (MRE) and computed tomography enterography (CTE) have become pivotal in evaluating bowel wall and extraintestinal involvement. This study aimed to compare the diagnostic efficacy and feature agreement between MRE and CTE in assessing key mural and extramural characteristics of IBD.Methods: A comparative cross-sectional study was conducted on patients diagnosed with IBD who underwent both MRE and CTE. Imaging findings were independently reviewed to assess diagnostic agreement on parameters including mural thickening, mural stratification, skip lesions, luminal stenosis, and creeping fat sign. Statistical analyses were performed using chi-square tests (χ²) and independent t-tests to evaluate agreement, discrepancies, and demographic correlations.Results: The mean age of participants was 43.40 ± 13.38 years (range: 20-63 years), with 19 (54.3%) patients diagnosed with CD and 16 (45.7%) with UC. No significant difference was observed in age between agreement and discrepancy groups (t = -0.05, p = 0.9611). Overall, MRE showed higher agreement with clinical diagnosis for mural stratification (p<0.05) and creeping fat (p<0.01) than CTE. Feature-wise comparison revealed agreement rates of 68.97% for mural thickening (χ² = 0.18, p = 0.6756), 74.19% for mural stratification (χ² = 0.0, p = 1.0), 66.67% for skip lesions (χ² = 0.0, p = 0.9901), 63.64% for luminal stenosis (χ² = 0.19, p = 0.6589), and 66.67% for creeping fat (χ² = 0.27, p = 0.6044).Conclusion: MRE and CTE demonstrated comparable diagnostic agreement in evaluating IBD features, with MRE offering superior tissue characterization and radiation-free imaging, while CTE provided faster acquisition and higher spatial resolution. Despite moderate agreement levels, both modalities remain complementary in clinical practice. MRE should be preferred for longitudinal follow-up, particularly in younger patients, given its safety profile and diagnostic comprehensiveness.

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