7T场强下获得的磁敏感加权成像（SWI）用于颞叶癫痫患者的定性评估及其与组织病理学和临床的相关性：一项初步的试点研究

Usage of SWI (susceptibility weighted imaging) acquired at 7T for qualitative evaluation of temporal lobe epilepsy patients with histopathological and clinical correlation: An initial pilot study.

作者信息

Kwan Benjamin Y M, Salehi Fateme, Ohorodnyk Pavlo, Lee Donald H, Burneo Jorge G, Mirsattari Seyed M, Steven David, Hammond Robert, Peters Terry M, Khan Ali R

机构信息

Department of Medical Imaging, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St. North, London, Ontario, N6A 5B7, Canada.

Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St. North, London, Ontario, N6A 5B7, Canada.

出版信息

J Neurol Sci. 2016 Oct 15;369:82-87. doi: 10.1016/j.jns.2016.07.066. Epub 2016 Aug 2.

DOI:10.1016/j.jns.2016.07.066

PMID:27653870

Abstract

OBJECTIVES

Ultra high field MRI at 7T is able to provide much improved spatial and contrast resolution which may aid in the diagnosis of hippocampal abnormalities. This paper presents a preliminary experience on qualitative evaluation of 7T MRI in temporal lobe epilepsy patients with a focus on comparison to histopathology.

METHODS

7T ultra high field MRI data, using T1-weighted, T2*-weighted and susceptibility-weighted images (SWI), were acquired for 13 patients with drug resistant temporal lobe epilepsy (TLE) during evaluation for potential epilepsy surgery. Qualitative evaluation of the imaging data for scan quality and presence of hippocampal and temporal lobe abnormalities were scored while blinded to the clinical data. Correlation of imaging findings with the clinical data was performed. Blinded evaluation of 1.5T scans was also performed.

RESULTS

On the 7T MRI findings, eight out of 13 cases demonstrated concordance with the clinically suspected TLE. Among these concordant cases, three exhibited supportive abnormal 7T MRI findings which were not detected by the clinical 1.5T MRI. Of the ten cases that progressed to epilepsy surgery, seven showed concordance between 7T MRI findings and histopathology; of these, four cases had hippocampal sclerosis. SWI had the highest concordance with the clinical and histopathological findings. Similar clinical and histopathological concordance was found with 1.5T MRI.

CONCLUSIONS

There was moderate and high concordance between the 7T imaging findings with the clinical data and histopathology respectively.

摘要

目的

7T 超高场磁共振成像（MRI）能够提供显著改善的空间分辨率和对比分辨率，这可能有助于诊断海马体异常。本文介绍了对颞叶癫痫患者进行 7T MRI 定性评估的初步经验，重点是与组织病理学进行比较。

方法

在对 13 例耐药性颞叶癫痫（TLE）患者进行潜在癫痫手术评估期间，使用 T1 加权、T2*加权和磁敏感加权成像（SWI）获取 7T 超高场 MRI 数据。在对临床数据不知情的情况下，对扫描质量以及海马体和颞叶异常情况的成像数据进行定性评估并打分。将成像结果与临床数据进行相关性分析。还对 1.5T 扫描进行了盲法评估。

结果

根据 7T MRI 结果，13 例中有 8 例与临床疑似的 TLE 相符。在这些相符的病例中，有 3 例表现出支持性的异常 7T MRI 结果，而临床 1.5T MRI 未检测到。在进展到癫痫手术的 10 例病例中，7 例 7T MRI 结果与组织病理学相符；其中，4 例有海马硬化。SWI 与临床和组织病理学结果的一致性最高。1.5T MRI 也发现了类似的临床和组织病理学一致性。