Imaging Analysis of Ganglioneuroma and Quantitative Analysis of Paraspinal Ganglioneuroma.

BACKGROUND This study evaluated the imaging features of ganglioneuroma (GN) and assessed the diagnostic value of the enhancement rate (ER) of CT for GN. MATERIAL AND METHODS We retrospectively reviewed records of 49 patients with histopathologically confirmed GN who underwent preoperative contrast-enhanced CT or MRI between 2010 and 2018. The independent samples t test and chi-square test were used. Receiver operating characteristic (ROC) curves were generated to analyze the diagnostic sensitivity (SE) and specificity (SP). Positive predictive value (PPV) and negative predictive value (NPV) were calculated. RESULTS The CT values were 32.59±3.61 Hounsfield units (HU) for plain scans, 38.87±5.09 HU for the arterial phase, and 54.26±8.14 HU for the venous phase, and the incidence of calcification and cysts was 32.6% and 10.2%, respectively. There was no significant difference in CT results and clinical parameters between mediastinal ganglioneuroma (MGN) and retroperitoneal ganglioneuroma (RGN) (p>0.05). The area under the curves (AUCs) for the arterial enhancement rate (AER), venous enhancement rate (VER), and AER/VER combined index in diagnosing GN were 0.735, 0.980, and 0.990, respectively. The VER of 0.2819 exhibited the SE and SP at 92.9% and 92.9%, respectively, to characterize the GN, whereas the AER of 0.1779 had SE and SP of 52.4% and 90.5%, respectively. The SE and SP for the combined index were 88.1% and 100%, respectively. The GN showed hypointensity on T1WI, hyperintense, or slightly high signal on T2WI with the linear hypointensity, and hyperintense on DWI. CONCLUSIONS A hypodense mass was observed for GN on plain scan and presented delayed enhancement on contrast enhancement. VER or AER/VER combination is more accurate than AER for the diagnosis of paravertebral GN.

A meta-analysis study of the association between EGFR rs2252586 mutation and the risk of glioma.

Several studies reported the association between Epidermal growth factor receptor (EGFR) rs2252586 mutation and glioma susceptibility. However, the results of these studies were inconsistent. A computer-based search using EMBASE and PubMed databases was conducted. Odds ratios (OR) and 95% confidence interval (CI) were used to assess the strength of association between EGFR rs2252586 mutation and glioma susceptibility. The EGFR rs2252586 mutation was significantly associated with an increased risk of glioma (OR=1.16; 95%CI, 1.11-1.21; P<0.00001). When stratified by tumor subtype, the significantly elevated risk was observed in glioblastoma (OR=1.15; 95%CI, 1.04-1.26; P=0.007) but not in oligodendroglioma (OR=1.19; 95%CI, 0.97-1.46; P=0.10). When we excluded the studies with small sample size (case number < 1000), a significant association between EGFR rs2252586 mutation and glioma susceptibility remained (OR=1.16; 95%CI, 1.09-1.22; P<0.00001). In conclusion, this meta-analysis found that EGFR rs2252586 mutation was significantly associated with glioma risk.

An MRI-Based Radiomics Nomogram for Differentiation of Benign and Malignant Vertebral Compression Fracture.

RATIONALE AND OBJECTIVES: This study aimed to develop and validate a magnetic resonance imaging (MRI)-based radiomics nomogram combining radiomics signatures and clinical factors to differentiate between benign and malignant vertebral compression fractures (VCFs). MATERIALS AND METHODS: A total of 189 patients with benign VCFs (n = 112) or malignant VCFs (n = 77) were divided into training (n = 133) and validation (n = 56) cohorts. Radiomics features were extracted from MRI T1-weighted images and short-TI inversion recovery images to develop the radiomics signature, and the Rad score was constructed using least absolute shrinkage and selection operator regression. Demographic and MRI morphological characteristics were assessed to build a clinical factor model using multivariate logistic regression analysis. A radiomics nomogram was constructed based on the Rad score and independent clinical factors. Finally, the diagnostic performance of the radiomics nomogram, clinical model, and radiomics signature was validated using receiver operating characteristic and decision curve analysis (DCA). RESULTS: Six features were used to build a combined radiomics model (combined-RS). Pedicle or posterior element involvement, paraspinal mass, and fluid sign were identified as the most important morphological factors for building the clinical factor model. The radiomics signature was superior to the clinical model in terms of the area under the curve (AUC), accuracy, and specificity. The radiomics nomogram integrating the combined-RS, pedicle or posterior element involvement, paraspinal mass, and fluid sign achieved favorable predictive efficacy, generating AUCs of 0.92 and 0.90 in the training and validation cohorts, respectively. The DCA indicated good clinical usefulness of the radiomics nomogram. CONCLUSION: The MRI-based radiomics nomogram, combining the radiomics signature and clinical factors, showed favorable predictive efficacy for differentiating benign from malignant VCFs.

Application of indocyanine green and near-infrared fluorescence imaging for the assessment of peritoneal dialysis-related complications.

Background Ultrasound, computed tomographic peritoneography, methylene blue, and peritoneal scintigraphy are commonly used to identify peritoneal dialysis-related complications in clinical settings. This study aimed to investigate the diagnostic value of indocyanine green in peritoneal dialysis-related complications and to study the effect of indocyanine green on residual renal function and peritoneal function. Methods Twenty male Sprague-Dawley rats were used to establish models, including a pleural effusion model (A, n = 4), abdominal hernia model (B, n = 4), subcutaneous leakage model (C, n = 4), and control (D, n = 8). They were injected with a 20 mL mixture of peritoneal dialysate and indocyanine green at varying concentrations prepared for near-infrared fluorescence imaging. We compared the results of near-infrared-I and near-infrared-II imaging. Radiologists evaluated the image quality, morphology, and thickness of the peritoneum, and the residual renal function was assessed using haematoxylin and eosin staining. Results Lesions in each rat model group were observed by changing the body position and imaging parameters. Pathological kidney and peritoneal sections showed no changes. Meanwhile, near-infrared-I fluorescence imaging of ICG has a better signal-to-background ratio than near-infrared-II. Conclusion Near-infrared-I fluorescence imaging of ICG has a better SBR than near-infrared-II and it is sufficient for for diagnosing peritoneal dialysis-related complications and ICG has no impact on residual renal function and peritoneal function. This method has clinical application potential in promptly diagnosing peritoneal dialysis-related complications.

Calcium pyrophosphate deposition disease of the temporomandibular joint invading the middle cranial fossa: Two case reports.

BACKGROUND: Pseudogout is a benign joint lesion caused by the deposition of calcium pyro-phosphate dihydrate crystals, but it is invasive. Pseudogout of the temporo-mandibular joint (TMJ) is uncommon, and it rarely invades the skull base or penetrates into the middle cranial fossa. The disease has no characteristic clinical manifestations and is easily misdiagnosed. CASE SUMMARY: We present two cases of tophaceous pseudogout of the TMJ invading the middle cranial fossa. A 46-year-old woman with a history of diabetes for more than 10 years was admitted to the hospital due to swelling and pain in the right temporal region. Another patient, a 52-year-old man with a mass in the left TMJ for 6 years, was admitted to the hospital. Maxillofacial imaging showed a calcified mass and severe bone destruction of the skull base in the TMJ area. Both patients underwent excision of the lesion. The lesion was pathologically diagnosed as tophaceous pseudogout. The symptoms in these patients were relieved after surgery. CONCLUSION: Tophaceous pseudogout should be considered when there is a calcified mass in the TMJ with or without bone destruction. A pathological examination is the gold standard for diagnosing this disease. Surgical treatment is currently the recommended treatment, and the prognosis is good after surgery.

Structural and functional brain abnormalities in postherpetic neuralgia: A systematic review of neuroimaging studies.

In recent decades, an increasing number of neuroimaging studies utilizing magnetic resonance imaging (MRI) have explored the differential effects of postherpetic neuralgia (PHN) on brain structure and function. We systematically reviewed and integrated the findings from relevant neuroimaging studies in PHN patients. A total of 15 studies with 16 datasets were ultimately included in the present study, which were categorized by the different neuroimaging modalities. The results revealed that PHN was closely associated with structural/microstructural and functional abnormalities of the brain mainly located in the 'pain matrix', including the thalamus, insula, parahippocampus, amygdala, dorsolateral prefrontal cortex, precentral gyrus and inferior parietal lobe, as well as other regions, such as the precuneus, lentiform nucleus and brainstem. Furthermore, a disruption of multiple networks, including the default-mode network, salience network and limbic system, may contribute to the neurophysiological mechanisms underlying PHN. The findings indicate that the cerebral abnormalities of PHN were not restricted to the pain matrix but extended to other regions, profoundly affecting the regulation and moderation of pain processing in PHN. Future prospective and longitudinal neuroimaging studies with larger samples will elucidate the progressive trajectory of neural changes in the pathophysiological process of PHN.

Inhibition of miR­101­3p protects against sepsis­induced myocardial injury by inhibiting MAPK and NF­κB pathway activation via the upregulation of DUSP1.

Numerous studies have found that microRNAs (miRNAs or miRs) are aberrantly expressed when sepsis occurs. The present study aimed to investigate the role of miR­101­3p in sepsis­induced myocardial injury and to elucidate the underlying mechanisms. Models of myocardial injury were established both in vivo and in vitro. The results revealed that miR­101­3p was upregulated in the serum of patients with sepsis­induced cardiomyopathy (SIC) and positively correlated with the levels of pro­inflammatory cytokines (including IL­1ß, IL­6 and TNF­α). Subsequently, rats were treated with miR­101­3p inhibitor to suppress miR­101­3p and were then exposed to lipopolysaccharide (LPS). The results revealed that LPS induced marked cardiac dysfunction, apoptosis and inflammation. The inhibition of miR­101­3p markedly attenuated sepsis­induced myocardial injury by attenuating apoptosis and the expression of pro­inflammatory cytokines. Mechanistically, dual specificity phosphatase­1 (DUSP1) was found to be a functional target of miR­101­3p. The downregulation of miR­101­3p led to the overexpression of DUSP1, and the inactivation of the MAPK p38 and NF­κB pathways. Moreover, blocking DUSP1 by short hairpin RNA against DUSP1 (sh­DUSP1) significantly reduced the myocardial protective effects mediated by the inhibition of miR­101­3p. Collectively, the findings of the present study demonstrate that the inhibition of miR­101­3p exerts cardioprotective effects by suppressing MAPK p38 and NF­κB pathway activation, and thus attenuating inflammation and apoptosis dependently by enhancing DUSP1 expression.

Assessment of thoracic aorta in different cardiac phases in patients with non-aorta diseases using cardiac CT.

The aim was to evaluate the thoracic aorta in different cardiac phases to obtain the correct cardiac phase for measuring the maximum diameter required to predict aortic disease. Cardiac CT was performed on 97 patients for suspected coronary artery disease. The average diameter of ascending (AAD) and descending aorta (DAD) in the plane of pulmonary bifurcation, in the plane of the sinus junction (AAD [STJ] and DAD [STJ]), descending aorta in the plane of the diaphragm (DAD [Dia]), the diameter of the main pulmonary artery (MPAD), distance from the sternum to the spine (S-SD), and distance from the sternum to the ascending aorta (S-AAD) were assessed at 20 different time points in the cardiac cycle. Differences in aortic diameter in different cardiac phases and the correlation between aortic diameter and traditional risk factors were analyzed by the general linear mixed model. The diameter of the thoracic aorta reached the minimum at the phase of 95-0%, and reached the maximum at 30-35%. The maximum values of AAD, AAD (STJ), DAD, DAD (STJ), and DAD (Dia) were 32.51 ± 3.35 mm, 28.86 ± 3.01 mm, 23.46 ± 2.88 mm, 21.85 ± 2.58 mm, and 21.09 ± 2.66 mm, respectively. The maximum values of MPAD/AAD and DAD/AAD (STJ) were 0.8140 ± 0.1029, 0.7623 ± 0.0799, respectively. The diameter of the thoracic aorta varies with the cardiac phase. Analyzing the changes in aortic diameter, which can be done using cardiac CT, could provide a more accurate clinical measurement for predicting aortic disease.

Altered gray matter volume and functional connectivity in patients with herpes zoster and postherpetic neuralgia.

Numerous neuroimaging studies on postherpetic neuralgia (PHN) and herpes zoster (HZ) have revealed abnormalities in brain structure/microstructure and function. However, few studies have focused on changes in gray matter (GM) volume and intrinsic functional connectivity (FC) in the transition from HZ to PHN. This study combined voxel-based morphometry and FC analysis methods to investigate GM volume and FC differences in 28 PHN patients, 25 HZ patients, and 21 well-matched healthy controls (HCs). Compared to HCs, PHN patients exhibited a reduction in GM volume in the bilateral putamen. Compared with HZ patients, PHN patients showed decreased GM volume in the left parahippocampal gyrus, putamen, anterior cingulate cortex, and right caudate and increased GM volume in the right thalamus. However, no regions with significant GM volume changes were found between the HZ and HC groups. Correlation analysis revealed that GM volume in the right putamen was positively associated with illness duration in PHN patients. Furthermore, lower FCs between the right putamen and right middle frontal gyrus/brainstem were observed in PHN patients than in HCs. These results indicate that aberrant GM volumes and FC in several brain regions, especially in the right putamen, are closely associated with chronification from HZ to PHN; moreover, these changes profoundly affect multiple dimensions of pain processing. These findings may provide new insights into the pathophysiological mechanisms of PHN.

Abnormalities of Cerebral White Matter Microstructure in Children With New-Onset, Untreated Idiopathic-Generalized Epilepsy.

Despite evidence for microstructural brain alterations in epilepsy patients, little is known about how these develop with age and the progress of the disease. The aim of this study was to investigate microstructural abnormalities of the white matter (WM) in children with new-onset, untreated idiopathic-generalized epilepsy (IGE) using the MRI technique of diffusion tensor imaging (DTI). The study was approved by the institutional review board, and all individuals or their parents gave signed informed consent. In total, 45 patients with IGE (age 5-18 years, male: female 26:19) and 32 healthy controls (HCs; age 5-18 years, male: female 21:11) were included. Voxel-based analysis (VBA) was used to compare patients and controls, and Pearson correlation analysis was used to investigate relationships between altered DTI metrics and clinical parameters. Compared with controls, patients with IGE showed increased mean diffusivity (MD) in the left splenium of the corpus callosum, increased fractional anisotropy (FA) in the right WM of the superior and middle frontal gyri, increased axial diffusivity (AD) in the WM of right corona radiata and left occipital lobe, and decreased AD in the WM of the left thalamus and the right middle cerebellar peduncle. There was no correlation between the altered diffusion parameters and clinical measures. Our study demonstrated several distinct microstructural impairments in children with new-onset, untreated IGE, of which altered AD might be the most sensitive marker of dysmyelination. The increased FA in the IGE group might suggest an initiating or compensatory mechanism that is activated prior to cognitive decline in these children.

Grey matter volume alterations in trigeminal neuralgia: A systematic review and meta-analysis of voxel-based morphometry studies.

In recent decades, a growing number of structural neuroimaging studies of grey matter (GM) in trigeminal neuralgia (TN) have reported inconsistent alterations. We carried out a systematic review and meta-analysis to identify consistent and replicable GM volume abnormalities using effect-size signed differential mapping (ES-SDM). Furthermore, we conducted a meta-regression to explore the potential effects of clinical characteristics on GM volume alterations in patients with TN. A total of 13 studies with 15 datasets, representing 407 TN patients and 376 healthy individuals, were included in the present study. The results revealed that TN patients had GM volume abnormalities mainly in the basal ganglia, including the putamen, nucleus accumbens (NAc), caudate nucleus and amygdala, as well as the cingulate cortex (CC), thalamus, insula and superior temporal gyrus (STG). The meta-regression analysis showed that verbal rating scale (VRS) scores were negatively correlated with decreased GM volume in the left striatum and that illness duration was negatively correlated with decreased GM volume in the left STG and left insula. These results provide a thorough profile of GM volume alterations in TN patients and constitute robust evidence that aberrant GM volumes in the brain regions regulating and moderating sensory-motor and affective processing may play an important role in the pathophysiology of TN.

Grading of Clear Cell Renal Cell Carcinomas by Using Machine Learning Based on Artificial Neural Networks and Radiomic Signatures Extracted From Multidetector Computed Tomography Images.

RATIONALE AND OBJECTIVES: To evaluate the ability of artificial neural networks (ANN) fed with radiomic signatures (RSs) extracted from multidetector computed tomography images in differentiating the histopathological grades of clear cell renal cell carcinomas (ccRCCs). MATERIALS AND METHODS: The multidetector computed tomography images of 227 ccRCCs were retrospectively analyzed. For each ccRCC, 14 conventional image features (CIFs) were extracted manually by two radiologists, and 556 texture features (TFs) were extracted by a free software application, MaZda (version 4.6). The high-dimensional dataset of these RSs was reduced using the least absolute shrinkage and selection operator. Five minimum mean squared error models (minMSEMs) for predicting the ccRCC histopathological grades were constructed from the CIFs, the TFs of the corticomedullary phase images (CMP), and the TFs of the parenchyma phase (PP) images and their combinations, respectively abbreviated as CIF-minMSEM, CMP-minMSEM, PP-minMSEM, CIF+CMP-minMSEM, and CIF+PP-minMSEM. The RSs of each model were fed 30 times consecutively into an ANN for machine learning, and the predictive accuracy of each time ML was recorded for the statistical analysis. RESULTS: The five predictive models were constructed from 12, 19, and 10 features selected from the CIFs, the TFs of the CMP images, and that of PP images, respectively. On the basis of their accuracy across the whole cohort, the five models were ranked as follows: CIF+CMP-minMSEM (accuracy: 94.06% ± 1.14%), CIF + PP-minMSEM (accuracy: 93.32% ± 1.23%), CIF-minMSEM (accuracy: 92.26% ± 1.65%), CMP-minMSEM (accuracy: 91.76% ± 1.74%), and PP-minMSEM (accuracy: 90.89% ± 1.47%). CONCLUSION: Machine learning based on ANN helped establish an optimal predictive model, and TFs contributed to the development of high accuracy predictive models. The CIF+CMP-minMSEM showed the greatest accuracy for differentiating low- and high-grade ccRCCs.

Neurosyphilis complicated with pial arteriovenous fistula: A rare case report.

INTRODUCTION: Neurosyphilis is a chronic, infectious disease of the central nervous system. Pial arteriovenous fistulae (PAVF) are rare vascular malformations. Both can cause vascular damage, but it is quite rare for both to present at the same time. PATIENT CONCERNS: Here we present a 66-year-old man with affective disorder, hypomnesia, and recent convulsions. Magnetic resonance imaging revealed cerebral swelling, hyperintensity in the cortex/subcortex, and multiple lacunar cerebral infarctions. Computed tomography angiography revealed the presence of a pial arteriovenous fistula. DIAGNOSES: Based on laboratory tests and imaging, diagnoses of neurosyphilis and pial arteriovenous fistula were made. INTERVENTIONS: Antisyphilis therapy was provided. OUTCOMES: Symptoms improved and antisyphilis treatment continued as an outpatient. No intracranial hemorrhage was seen 6 months later. CONCLUSION: Treponema pallidum infection may be related to the formation of PAVF, and may also promote the progression of it; however, further work is required to confirm this.

Cause of postprandial vomiting - a giant retroperitoneal ganglioneuroma enclosing large blood vessels: A case report.

BACKGROUND: Ganglioneuroma (GN) is a rare neurogenic tumor that accounts for about 0.1%-0.5% of all tumors of the nervous system. It originates from neural crest cells. GN has no specific clinical symptoms or laboratory findings, which leaves it easily overlooked and misdiagnosed as other tumors. Retroperitoneal GN with very large volume and vascular penetration is extremely rare. CASE SUMMARY: We present the imaging and pathological findings of a giant retroperitoneal GN in a child. A 4-year-old boy had suffered from postprandial vomiting for more than 6 mo with no precipitating factors. Abdominal computerized tomographic examination showed a giant cystic mass in the retroperitoneal area. After injection of contrast agent, the mass showed heterogeneous enhancement. Surgery with local excision of the mass was performed to address the embedded abdominal blood vessels, and the histopathological and immunohistochemical diagnosis of the mass was GN. Postprandial vomiting was relieved, and no complications occurred after the operation. CONCLUSION: In the diagnosis of giant retroperitoneal hypodense masses in children, GN should be considered if the mass presents delayed enhancement, punctate calcification, and vascular embedding but no invasion. Pathology is the golden standard for the diagnosis of GN, and surgical excision is the optimal treatment for GN.

Predictive models composed by radiomic features extracted from multi-detector computed tomography images for predicting low- and high- grade clear cell renal cell carcinoma: A STARD-compliant article.

To evaluate the values of conventional image features (CIFs) and radiomic features (RFs) extracted from multi-detector computed tomography (MDCT) images for predicting low- and high-grade clear cell renal cell carcinoma (ccRCC).Two hundred twenty-seven patients with ccRCC were retrospectively recruited. Five hundred seventy features including 14 CIFs and 556 RFs were extracted from MDCT images of each ccRCC. The CIFs were extracted manually and RFs by the free software-MaZda. Least absolute shrinkage and selection operator (Lasso) was applied to shrink the high-dimensional data set and select the features. Five predictive models for predicting low- and high-grade ccRCC were constructed by the selected CIFs and RFs. The 5 models were as follows: model of minimum mean squared error (minMSE) of CIFs (CIF-minMSE), minMSE of cortico-medullary phase (CMP) of kidney (CMP-minMSE), minMSE of parenchyma phase (PP) of kidney (PP-minMSE), the combined model of CIF-minMSE and CMP-minMSE (CIF-CMP-minMSE), and the combined model of CIF-minMSE and PP-minMSE (CIF-PP-minMSE). The Lasso regression equation of each model was constructed, and the predictive values were calculated. The receiver operating characteristic (ROC) curves of predictive values of the 5 models were drawn by SPSS19.0, and the areas under the curves (AUCs) were calculated.According to Lasso regression, 12, 19 and 10 features were respectively selected from the CIFs, RFs of CMP image and that of PP images to construct the 5 predictive models. The models ordered by their AUCs from large to small were CIF-CMP-minMSE (AUC: 0.986), CIF-PP-minMSE (AUC: 0.981), CIF-minMSE (AUC: 0.980), CMP-minMSE (AUC: 0.975), and PP-minMSE (AUC: 0.963). The maximum diameter of the largest axial section of ccRCC had a maximum weight in predicting the grade of ccRCC among all the features, and its cutoff value was 6.15 cm with a sensitivity of 0.901, a specificity of 0.963, and an AUC of 0.975.When combined with CIFs, RFs extracted from MDCT images contributed to the larger AUC of the predictive model, but were less valuable than CIFs when used alone. The CIF-CMP-minMSE was the optimal predictive model. The maximum diameter of the largest axial section of ccRCC had the largest weight in all features.

Angiomatoid Fibrous Histiocytoma Mimicking Eosinophilic Granuloma in a Pediatric Patient.

BACKGROUND: Angiomatoid fibrous histiocytoma (AFH) is a rare low-grade malignant tumor mainly occurring in soft tissues, and its incidence in the bones is extremely rare. Although most of the existing reports focus on the pathological features of AFH, only a few describe its imaging features. To our knowledge, this is the first case of AFH in the skull, and it is distinguished from eosinophilic granuloma based on imaging results. CASE DESCRIPTION: A boy aged 10 years presented with a painless mass of parietal bone after trauma. Cranial computed tomography angiography showed local bone defects near the sagittal suture of the left parietal bone and a soft tissue mass with relatively uniform density in the same area. The signals of this mass were heterogeneous in all sequences of magnetic resonance imaging and presented septal enhancement after the injection of contrast agent. The patient underwent complete resection of the mass, and the histopathological and immunohistochemical diagnosis of the mass was AFH. No complications occurred after the operation and no recurrence occurred during the follow-up. CONCLUSIONS: To our knowledge, this is the first AFH that occured in the skull, and the main imaging manifestations of AFH are bone destruction with soft tissue mass. The characteristic features of AFH are its fibrillar component that showed low signal on T2-weighted imaging and septal or peripheral enhancement, and no dead bone in the mass.

Cortical morphologic changes in recent-onset, drug-naïve idiopathic generalized epilepsy.

PURPOSE: Only a few studies have investigated the brain morphology abnormalities in structural MRI in patients with drug-naïve idiopathic generalized epilepsy (IGE) and mainly focused on brain volume changes. In the present study, we aimed to investigate the changes in three morphologic measurement differences including cortical thickness, cortical volume, and surface area using FreeSurfer in a pediatric cohort of recent-onset, drug-naïve IGE. METHODS: Forty-five recent-onset, drug-naïve patients diagnosed with IGE and 32 demographically matched healthy controls were recruited. All participants underwent structural MRI scans with a 3.0 T MR system. FreeSurfer, an automated cortical surface reconstruction toolbox, was applied to compare the cortical morphology between patients and controls. The brain regions with significant group differences after multiple comparison correction were extracted in common space for each patient, and then correlated with their clinical characteristics (including onset age, duration of epilepsy, and mini-mental state examination (MMSE)) using partial correlation analysis with age, sex and intracranial volume as covariates. RESULTS: Compared with controls, IGE patients showed decreased cortical thickness in the left rostral middle frontal gyrus, decreased cortical volume in the right cuneus and left superior frontal gyrus that extended to the precentral gyrus, and decreased surface area in the right cuneus and right inferior parietal gyrus. None of these regions showed significant relationships with clinical measurements in the patient group. CONCLUSION: Our findings suggest that cortical thickness, cortical volume, and surface area changes occurred in the early stage of IGE. These findings provide structural neuroimaging evidence underlying the pathology of IGE.