Coan A C, Kubota B, Bergo F P G, Campos B M, Cendes F
Neuroimaging Laboratory, Department of Neurology, State University of Campinas, Campinas, São Paulo, Brazil.
AJNR Am J Neuroradiol. 2014 Jan;35(1):77-83. doi: 10.3174/ajnr.A3640. Epub 2013 Jul 18.
In mesial temporal lobe epilepsy, MR imaging quantification of hippocampal volume and T2 signal can improve the sensitivity for detecting hippocampal sclerosis. However, the current contributions of these analyses for the diagnosis of hippocampal sclerosis in 3T MRI are not clear. Our aim was to compare visual analysis, volumetry, and signal quantification of the hippocampus for detecting hippocampal sclerosis in 3T MRI.
Two hundred three patients with mesial temporal lobe epilepsy defined by clinical and electroencephalogram criteria had 3T MRI visually analyzed by imaging epilepsy experts. As a second step, we performed automatic quantification of hippocampal volumes with FreeSurfer and T2 relaxometry with an in-house software. MRI of 79 healthy controls was used for comparison.
Visual analysis classified 125 patients (62%) as having signs of hippocampal sclerosis and 78 (38%) as having normal MRI findings. Automatic volumetry detected atrophy in 119 (95%) patients with visually detected hippocampal sclerosis and in 10 (13%) with visually normal MR imaging findings. Relaxometry analysis detected hyperintense T2 signal in 103 (82%) patients with visually detected hippocampal sclerosis and in 15 (19%) with visually normal MR imaging findings. Considered together, volumetry plus relaxometry detected signs of hippocampal sclerosis in all except 1 (99%) patient with visually detected hippocampal sclerosis and in 22 (28%) with visually normal MR imaging findings.
In 3T MRI visually inspected by experts, quantification of hippocampal volume and signal can increase the detection of hippocampal sclerosis in 28% of patients with mesial temporal lobe epilepsy.
在颞叶内侧癫痫中，海马体积和T2信号的磁共振成像（MR）定量分析可提高检测海马硬化的敏感性。然而，目前这些分析在3T磁共振成像中对海马硬化诊断的贡献尚不清楚。我们的目的是比较在3T磁共振成像中对海马进行视觉分析、体积测量和信号定量分析以检测海马硬化的情况。
203例根据临床和脑电图标准确诊为颞叶内侧癫痫的患者接受了3T磁共振成像检查，由癫痫影像专家进行视觉分析。第二步，我们使用FreeSurfer软件进行海马体积的自动定量分析，并使用内部软件进行T2弛豫测量。选取79例健康对照者的磁共振成像用于比较。
视觉分析将125例患者（62%）分类为有海马硬化迹象，78例（38%）为磁共振成像结果正常。自动体积测量在119例（95%）视觉检测有海马硬化的患者以及10例（13%）视觉磁共振成像结果正常的患者中检测到萎缩。弛豫测量分析在103例（82%）视觉检测有海马硬化的患者以及15例（19%）视觉磁共振成像结果正常的患者中检测到T2信号高增强。综合来看，体积测量加弛豫测量在除1例（99%）视觉检测有海马硬化的患者外的所有患者中以及22例（28%）视觉磁共振成像结果正常的患者中检测到海马硬化迹象。
在专家进行视觉检查的3T磁共振成像中，海马体积和信号的定量分析可使28%的颞叶内侧癫痫患者中检测到海马硬化。
