Grey-white matter abnormalities in temporal lobe epilepsy associated with hippocampal sclerosis: inter-observer analysis, histopathological findings, and correlation with other variables
Abstract number :
1.216
Submission category :
5. Neuro Imaging
Year :
2011
Submission ID :
14630
Source :
www.aesnet.org
Presentation date :
12/2/2011 12:00:00 AM
Published date :
Oct 4, 2011, 07:57 AM
Authors :
R. Kuba, I. Tyrlikova, M. Pazourkova, M. Hermanova, M. Brazdil, I. Rektor
Rationale: The aim of this retrospective study was to assess an inter-observer analysis of grey-white matter abnormalities (GWMA) of the temporal pole (TP) in magnetic resonance imaging (MRI) of patients with mesial-temporal lobe epilepsy associated with hippocampal sclerosis (MTLE/HS) and to analyze the correlation of GWMA with other clinical variables.Methods: We included 55 patients with histologically proven HS (22 men, 33 women; average age of 39.6 years; average epilepsy duration of 27.6 years; and average epilepsy onset at 12.0 years of age. Three independent observers analysed the preoperative MRI and decided whether GWMA were present.Results: The inter-observer agreement (three observers 2 epileptologists, 1 neuroradiologist) on the presence or absence of GWMA was 79% (Fleiss kappa = 0.732; p<0.0001). GWMA were present in 21 out of 55 patients (38%). In total, focal cortical dysplasia (FCD) of type Ia or Ib (Palmini classification) was present in 17 out of 55 patients (31%). The statistical analysis showed a positive correlation between the presence or absence of GWMA and FCD of the TP (Pearson Chi-square, p=0.007) We did not find any statistically significant differences in the postoperative outcomes of patients with or without GWMA or FCD of the TP (Mann-Whitney test). We did not find any statistically significant difference in the presence or absence of GWMA and FCD of the TP in relation to the onset of active epilepsy, the duration of epilepsy, or the presence of potential epileptogenic insults (febrile seizures, encephalitis, head trauma) (ANOVA, Pearson Chi Square). Conclusions: GWMA of the TP in MRI of patients with MTLE/HS is a reliable assessment sign for observers who are experienced in evaluating MRIs of refractory epilepsy patients. The presence of GWMA of the TP is positively correlated with the presence of FCD type I of the TP in the histopathological evaluation of patients with MTLE/HS. The presence or absence of GWMA and FCD type I of the TP does not influence the postoperative outcome of MTLE/HS patients.
Neuroimaging