MRI IN THE PRESURGICAL EVALUATION OF PATIENTS WITH FRONTAL-LOBE EPILEPSY AND CHILDREN WITH TEMPORAL-LOBE EPILEPSY - PATHOLOGICAL CORRELATION AND PROGNOSTIC IMPORTANCE
MRI IN THE PRESURGICAL EVALUATION OF PATIENTS WITH FRONTAL-LOBE EPILEPSY AND CHILDREN WITH TEMPORAL-LOBE EPILEPSY - PATHOLOGICAL CORRELATION AND PROGNOSTIC IMPORTANCE
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DOI：
10.1016/0920-1211(92)90021-k
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发表时间：
1992-03-01
影响因子：
2.2
通讯作者：
TRENERRY, MR
中科院分区：
文献类型：
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作者：
CASCINO, GD;JACK, CR;TRENERRY, MR
我们使用高场强磁铁(1.5T)对两组53例顽固性部分性额叶或颞叶癫痫患者进行了磁共振成像(MRI)，这些患者后来因癫痫发作障碍而接受了消融手术。在第一组患者中，对额叶MRI确定的病变的病理相关性和预后重要性进行了评估。在MRI检查阴性的患者中，25%的患者和67%的神经成像异常患者仅限于额叶，在至少1年的随访期内，他们没有癫痫发作。有多叶MRI异常的患者术后无一例无癫痫发作。在第二项研究中，基于MRI的海马区体积测量的敏感性和特异性被确定在儿童患者中，其起源于颞叶的部分癫痫与异物组织病理无关。在63%的癫痫患者中，发现了癫痫发作时颞叶的海马结构萎缩。海马体积测定对内侧颞叶硬化症的敏感性和特异性均为100%。MRI检测到的额叶致痫灶和颞叶海马结构萎缩的存在可能与潜在的病理相关，并影响癫痫手术的潜在候选者的识别。
We performed magnetic resonance imaging (MRI) using a high-field strength magnet (1.5 T) in two series of 53 patients with intractable partial epilepsy of frontal lobe or temporal lobe origin who subsequently received ablative surgery for their seizure disorder. In the first series of patients the pathologic correlation and prognostic importance of an MRI-identified lesion in the frontal lobe were assessed. Twenty-five percent of the patients with negative MRI studies and 67% of patients with neuroimaging abnormalities restricted to the frontal lobe, were seizure-free at a minimum duration of follow-up of 1 year. None of the patients with a multilobar MRI-detected abnormality was seizure-free postoperatively. In the second study the sensitivity and specificity of MRI-based hippocampal volumetry was determined in pediatric patients with partial epilepsy of temporal lobe origin unrelated to foreign-tissue pathology. Hippocampal formation atrophy in the epileptic temporal lobe was identified in 63% of patients. The sensitivity and specificity of hippocampal volumetry was 100% in patients with mesial temporal sclerosis. The presence of an MRI-detected epileptogenic lesion in the frontal lobe and hippocampal formation atrophy in the temporal lobe may correlate with the underlying pathology and affect the identification of potential candidates for epilepsy surgery.