Quantitative Analysis of FLAIR MR Images for Presurgical Diagnosis of Hippocampal Sclerosis in Patients with Mesial Temporal Lobe Epilepsy.
Abstract number :
1.253
Submission category :
Year :
2001
Submission ID :
1664
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
Y-M. Shon, MD., Neurology, Samsung Medical Center, Seoul; S.B. Hong, MD., neurology, Samsung Medical Center, Seoul; E.K. Lee, Neurology, Samsung Medical Center, Seoul; W.S. Tae, Neurology, Samsung Medical Center, Seoul; D.W. Seo, MD., Neurology, Samsung M
RATIONALE: The typical MRI features of hippocampal sclerosis (HS) are volume loss and increased T2 weighted signal intensity. Volumetry and T2 relaxometry are useful quantitative methods for presurgical diagnosis of HS, especially in cases of mild, bilateral or focal hippocampal atrophies. We investigated the value of new quantitative method using FLAIR (Fluid Attenuated Inversion Recovery) MR images, compared to those of visual interpretation and MR volumetry.
METHODS: Fifty-six patients with mesial temporal lobe epilepsy (TLE) and 21 normal controls had volumetric MRI (T1-weighted, SPGR, T2 weighted, and FLAIR images). All patients underwent temporal lobectomy. Visual analysis and hippocampal volumetry were performed. The absolute and normalized (hippocampal FLAIR intensity/superior frontal FLAIR intensity = HFSR) values of hippocampal FLAIR intensity were obtained in both normal subjects and patients with TLE.
RESULTS: The pathology of resected hippocampus showed HS in all patients. Visual MRI interpretation failed to lateralize HS in 12 patients (21.4%). Among these 12 patients, HS was lateralized by HFSR in 8 (66.7%) [5 patients (41.7%) by HFSR R-L difference and another 3 patients (25%) by analysis of a longitudinal regional HFSR curve] while MR volumetry could lateralize hippocampal atrophy in only 4.
CONCLUSIONS: In presurgical diagnosis of HS, the quantitative FLAIR method appeared to be more sensitive than visual interpretation and MR volumetry.