Utility of 7 tesla MRI brain in 16 "MRI Negative" epilepsy patients and their surgical outcomes.
Utility of 7 tesla MRI brain in 16 "MRI Negative" epilepsy patients and their surgical outcomes.
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DOI：
10.1016/j.ebr.2020.100424
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发表时间：
2021
影响因子：
--
通讯作者：
Balchandani P
中科院分区：
文献类型：
--
作者：
Sharma HK;Feldman R;Delman B;Rutland J;Marcuse LV;Fields MC;Ghatan S;Panov F;Singh A;Balchandani P
16例MRI阴性癫痫患者7T病灶的病例研究。在7T上有明确发现的患者更有可能对手术做出反应。7T检查结果不明确的患者手术获益率较低。7T可能在癫痫的外科治疗中有进一步的用途。目的是定量评估在常规场强（1.5T/3T）下无法检测到病变的7T MRI扫描癫痫患者的手术结局。16名接受初始1.5T/3T扫描的患者被神经放射科医生标记为非病变，并且是癫痫手术的候选人，在7T下进行扫描。7T结果由对可疑癫痫发作区（sSOZ）不知情的神经放射学专家进行评价。将神经放射科医生的发现与sSOZ的关系分类为不确定（无7T病变或无致癫痫意义的病变，或致癫痫电位病变定位于患者的sSOZ但不是确定原因）或确定（致癫痫电位的7T病变高度定位于sSOZ并通过手术干预证实）。每例患者都接受了神经外科干预，并通过癫痫科医生的回顾性图表审查获得了术后恩格尔结果。16例患者中，7例在7T下有明确的致痫电位，9例有不明确的致痫电位。16例患者中有15例的Engel I、II或III级结局表明值得改善。病变状态明确的患者达到Engel I手术结局的比率（57.1%）高于病变状态不明确的患者（33.3%）。在较低场强下进行正常临床诊断扫描的患者，如果在7T上有明确的放射学发现（对应于sSOZ），则手术干预可能会带来值得改善的结果。
Case study of 16 MRI negative epilepsy patients with lesions on 7T. Patients with definite findings on 7T are more likely to respond to surgery. Patients with non-definite findings on 7T benefited from surgery at lower rates. 7T may have further utility in surgical treatment of epilepsy. The objective is to quantitatively assess surgical outcomes in epilepsy patients who underwent scanning at 7T MRI whose lesions were undetectable at conventional field strengths (1.5T/3T). 16 patients who underwent an initial 1.5T/3T scan that was marked as non-lesional by a neuroradiologist and were candidates for epilepsy surgery were scanned at 7T. The 7T findings were evaluated by an expert neuroradiologist blinded to the suspected seizure onset zone (sSOZ). The relation of the neuroradiologist’s findings compared with the sSOZ was classified as non-definite (no 7T lesion or lesion of no epileptogenic significance, or lesion of epileptogenic potential which localizes to the patient’s sSOZ but is not the definitive cause), or definite (7T lesion of epileptogenic potential that highly localizes to the sSOZ and is confirmed through surgical intervention).. Each patient underwent neurosurgical intervention and postoperative Engel outcomes were obtained through retrospective chart review by an epileptologist. Of the 16 patients, 7 had imaging findings of definite epileptogenic potential at 7T while 9 had non-definite imaging findings. 15 out of 16 patients had Engel I, II, or III outcomes indicating worthwhile improvement. Patients with definite lesion status achieved Engel I surgical outcomes at higher rates (57.1%) than patients with non-definite lesion status (33.3%). Patients with normal clinical diagnostic scans at lower field strengths who have definite radiological findings on 7T corresponding to the sSOZ may experience worthwhile improvement from surgical intervention.
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影响因子：
3.7
作者：
Feldman, Rebecca Emily;Delman, Bradley Neil;Balchandani, Priti
通讯作者：
Balchandani, Priti
影响因子：
3
作者：
Veersema TJ;Ferrier CH;van Eijsden P;Gosselaar PH;Aronica E;Visser F;Zwanenburg JM;de Kort GAP;Hendrikse J;Luijten PR;Braun KPJ
通讯作者：
Braun KPJ
影响因子：
158.5
作者：
Kwan, P;Brodie, MJ
通讯作者：
Brodie, MJ
DOI：
10.3174/ajnr.a4180
发表时间：
2015-07
期刊：
AJNR. American journal of neuroradiology
影响因子：
--
作者：
Balchandani P;Naidich TP
通讯作者：
Naidich TP