Hippocampal MRI signal hyperintensity after febrile status epilepticus is predictive of subsequent mesial temporal sclerosis
Hippocampal MRI signal hyperintensity after febrile status epilepticus is predictive of subsequent mesial temporal sclerosis
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DOI：
10.2214/ajr.07.2407
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发表时间：
2008-04-01
影响因子：
5
通讯作者：
Lewis, Darrell V.
中科院分区：
文献类型：
--
作者：
Provenzale, James M.;Barboriak, Daniel P.;Lewis, Darrell V.
客观的。我们研究的目的是检验以下假设：发热性癫痫持续状态后不久在 T2 加权 MR 图像上发现高信号海马信号强度与随后的海马体积损失和 T2 加权图像上持续的异常信号强度（即颞叶内侧硬化）相关。 对象和方法。 11 名儿童（平均年龄为 25 个月）接受了初始 MRI，其中包括发热性癫痫持续状态 72 小时内的冠状颞叶成像以及 3 至 23 个月后（平均 9 个月）的随访成像。神经放射科医生对临床病史不知情，将初始和后续海马信号强度按 0（正常）到 4（显着增加）分级。两名盲人观察者使用市售软件测量了初始和后续 MR 研究中的海马体积以及 30 名健康儿童（平均年龄 6.3 岁）的海马体积。使用 Kendall tau 相关系数比较初始信号强度和海马体积变化。结果。初始成像时，7 名儿童的高信号强度范围为 1（最小增加）到 4（显着增加）。 4 名儿童至少有一个海马体有中度或明显的信号异常，3 名儿童的海马体有轻度或极轻微的异常，4 名儿童的信号强度正常。信号强度增加和体积变化之间的 Kendall tau 相关系数为 -0.68 (p < 0.01)。五名儿童（两名患有颞叶癫痫，两名患有复杂部分性癫痫）在随访成像中出现海马体积减少和信号强度增加，符合内侧颞叶硬化的标准。结论。发热性癫痫持续状态儿童的海马区 MRI 发现明显高信号，与随后的内侧颞叶硬化高度相关。
OBJECTIVE. The objective of our study was to test the hypothesis that the finding of hyperintense hippocampal signal intensity on T2-weighted MR images soon after febrile status epilepticus is associated with subsequent hippocampal volume loss and persistent abnormal signal intensity on T2-weighted images (i.e., mesial temporal sclerosis).SUBJECTS AND METHODS. Eleven children (mean age, 25 months) underwent initial MRI that included coronal temporal lobe imaging within 72 hours of febrile status epilepticus and follow-up imaging from 3 to 23 months later (mean, 9 months). A neuroradiologist blinded to clinical history graded initial and follow-up hippocampal signal intensity on a scale from 0 (normal) to 4 (markedly increased). Two blinded observers measured hippocampal volumes on initial and follow-up MR studies using commercially available software and volumes from 30 healthy children (mean age, 6.3 years). Initial signal intensity and hippocampal volume changes were compared using Kendall tau correlation coefficients.RESULTS. On initial imaging, hyperintense signal intensity ranging from 1 (minimally increased) to 4 (markedly increased) was seen in seven children. Four children had at least one hippocampus with moderate or marked signal abnormality, three children had a hippocampus with mild or minimal abnormality, and four children had normal signal intensity. The Kendall tau correlation coefficient between signal intensity increase and volume change was -0.68 (p < 0.01). Five children (two with temporal lobe epilepsy and two with complex partial seizures) had hippocampal volume loss and increased signal intensity on follow-up imaging, meeting the criteria for mesial temporal sclerosis.CONCLUSION. MRI findings of a markedly hyperintense hippocampus in children with febrile status epilepticus was highly associated with subsequent mesial temporal sclerosis.