Zijlmans Maeike, de Kort Gérard A P, Witkamp Theodore D, Huiskamp Geertjan M, Seppenwoolde Jan-Henry, van Huffelen Alexander C, Leijten Frans S S
Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, The Netherlands.
J Magn Reson Imaging. 2009 Aug;30(2):256-62. doi: 10.1002/jmri.21811.
To study 3T compared to 1.5T phased array magnetic resonance imaging (MRI) in the presurgical work-up of patients with epilepsy with complex focus localization.
In all, 37 patients (>10 years) in preoperative work-up for epilepsy surgery were offered 3T in addition to 1.5T MRI if ambiguity existed about the epileptic focus. Scans were randomly reviewed by two observers, blinded for prior imaging, patient-identifying information, and each other's assessments, followed by a consensus meeting. The number of abnormal scans, detected lesions, and interobserver agreement were calculated and compared. The final consensus was compared to original scan reports.
One observer identified 22 lesions in both 3 and 1.5T scans, while the second identified more lesions in 1.5T scans (28 vs. 20). 3T MRI had better interobserver agreement. 3T revealed more dysplasias, while 1.5T revealed more tissue loss and mesial temporal sclerosis (MTS). The final consensus yielded 29 lesions, whereas original reports identified only 17 lesions.
The 3T scans revealed different lesions compared to 1.5T. Patients can benefit most from 3T scans when a dysplasia is suspected. Reevaluation by another experienced neuroradiologist is advised in case of negative or equivocal MRIs.
研究3T与1.5T相控阵磁共振成像（MRI）在癫痫病灶定位复杂患者术前检查中的应用。
共有37例（>10岁）癫痫手术术前检查患者，若癫痫病灶存在模糊不清的情况，则除了进行1.5T MRI检查外，还接受3T MRI检查。扫描结果由两名观察者随机审阅，他们对先前的影像、患者识别信息以及彼此的评估均不知情，随后进行共识会议。计算并比较异常扫描的数量、检测到的病变以及观察者间的一致性。将最终共识与原始扫描报告进行比较。
一名观察者在3T和1.5T扫描中均识别出22个病变，而另一名观察者在1.5T扫描中识别出更多病变（28个对20个）。3T MRI的观察者间一致性更好。3T显示出更多发育异常，而1.5T显示出更多组织丢失和内侧颞叶硬化（MTS）。最终共识得出29个病变，而原始报告仅识别出17个病变。
与1.5T相比，3T扫描显示出不同的病变。当怀疑有发育异常时，患者能从3T扫描中获益最多。若MRI检查结果为阴性或不明确，建议由另一位经验丰富的神经放射科医生进行重新评估。
