Eriksson Sofia H, Thom Maria, Bartlett Philippa A, Symms Mark R, McEvoy Andrew W, Sisodiya Sanjay M, Duncan John S
Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK.
Epilepsia. 2008 Jan;49(1):33-9. doi: 10.1111/j.1528-1167.2007.01277.x. Epub 2007 Sep 18.
Hippocampal sclerosis (HS) is the most common cause of refractory temporal lobe epilepsy. Histopathologically, HS is characterized by neuron loss and gliosis. HS can be identified on MRI by signal increase on T(2)-weighted images and volume loss on T(1)-weighted volume images. The Periodically Rotated Overlapping Parallel Lines with Enhanced Reconstruction ("PROPELLER") sequence has excellent contrast between grey and white matter and compensates for subjects moving during the scan. The aim of the current report was to explore PROPELLER image quality of the hippocampus compared to routine sequences.
Routine sequences (T(1) volume, T(2)-weighted, PD and FLAIR images) and PROPELLER images were acquired in four presurgical patients with HS using a GE 3T Excite HD scanner (General Electric). Resected tissue was stained with LFB, and for GFAP, NeuN and dynorphin immunohistochemistry. Hippocampal sections were compared with PROPELLER images.
PROPELLER images were T(2)-weighted and had superior tissue contrast compared to routine sequences. PROPELLER images showed the internal hippocampal structures and tissue changes associated with HS. This corresponded to changes seen on histopathological sections confirming that the sequence could distinguish between different strata and subfields of the hippocampus.
The PROPELLER sequence shows promise for detailed in vivo imaging of the hippocampus in patients who did not move overtly, negating the inevitable subtle movements during scans. More detailed in vivo studies of the hippocampal formation, investigating subtle abnormalities such as end folium sclerosis, and the neocortex are now possible and may increase the diagnostic yield of MRI.
海马硬化（HS）是难治性颞叶癫痫最常见的病因。组织病理学上，HS的特征是神经元丢失和胶质增生。HS在磁共振成像（MRI）上可通过T2加权图像信号增强和T1加权容积图像上的容积减小来识别。周期性旋转重叠平行线增强重建（“螺旋桨”）序列在灰质和白质之间具有出色的对比度，并能补偿扫描过程中受试者的移动。本报告的目的是探讨与常规序列相比，螺旋桨序列对海马的图像质量。
使用GE 3T Excite HD扫描仪（通用电气公司）对4例术前HS患者采集常规序列（T1容积、T2加权、质子密度加权和液体衰减反转恢复图像）和螺旋桨图像。切除的组织用Luxol固蓝染色，并进行胶质纤维酸性蛋白（GFAP）、神经元核抗原（NeuN）和强啡肽免疫组织化学染色。将海马切片与螺旋桨图像进行比较。
螺旋桨图像为T2加权，与常规序列相比具有更好的组织对比度。螺旋桨图像显示了海马内部结构以及与HS相关的组织变化。这与组织病理学切片上所见的变化一致，证实该序列可以区分海马的不同层和亚区。
螺旋桨序列对于未发生明显移动的患者海马的详细活体成像显示出前景，消除了扫描过程中不可避免的细微移动。现在有可能对海马结构进行更详细的活体研究，研究诸如终叶硬化等细微异常以及新皮质，这可能会提高MRI的诊断率。
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