Abstract：
OBJECT:The use of T2 relaxometry was investigated to detect non-sclerotic epileptogenic abnormality of the hippocampus in presurgical evaluation of temporal lobe epilepsy (TLE). METHODS:This prospective study included 30 patients who underwent hippocampectomy as part of surgical treatment of refractory TLE. Ten patients had structural epileptogenic lesions in the extra-hippocampal temporal lobe. Twelve patients underwent intracranial electroencephalography (iEEG) study before surgery. Visual assessment of atrophy and increased T2 signal intensity, volumetry, and T2 relaxometry of hippocampus were performed pre-operatively using 3T magnetic resonance imaging, and compared with the neuropathological findings and iEEG findings. Magnetic resonance imaging of 30 age- and sex-matched healthy controls was used to establish normal values, which were defined as z score within 2. RESULTS:Visual assessment, volumetry, and T2 relaxometry detected hippocampal abnormalities on the surgical side in 16 (53%), 16 (53%), and 26 (87%) patients, respectively. Hippocampal volume loss was always associated with prolonged T2 relaxation time, and supported by histopathological diagnosis of HS in all cases except one. Hippocampal abnormality was detected only by T2 relaxometry in nine patients (30%). Pathological diagnosis of these cases included mild HS in one, microdysgenesis in one, and granule cell pathology in three. Four patients with normal hippocampal volume and T2 relaxation time had no HS or granule cell pathology. Prolonged T2 relaxation time was associated with medial temporal seizure onset in iEEG (p<0.05). CONCLUSIONS:T2 relaxometry improves the detection of non-sclerotic epileptogenic abnormality of the hippocampus.
journal_name
Epilepsy Resjournal_title
Epilepsy researchauthors
Sato S,Iwasaki M,Suzuki H,Mugikura S,Jin K,Tominaga T,Takase K,Takahashi S,Nakasato Ndoi
10.1016/j.eplepsyres.2016.06.001subject
Has Abstractpub_date
2016-10-01 00:00:00pages
1-9eissn
0920-1211issn
1872-6844pii
S0920-1211(16)30087-0journal_volume
126pub_type
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