SUrface-PRojected FLuid-Attenuation- Inversion-Recovery Analysis: A Novel Tool for Advanced Imaging of Epilepsy
SUrface-PRojected FLuid-Attenuation- Inversion-Recovery Analysis: A Novel Tool for Advanced Imaging of Epilepsy
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DOI：
10.1016/j.wneu.2016.11.100
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发表时间：
2017-02-01
影响因子：
2
通讯作者：
Colombo, Nadia
中科院分区：
文献类型：
--
作者：
Cardinale, Francesco;Francione, Stefano;Colombo, Nadia
目的：这项试点回顾性研究的目的是描述的表面PROJECTED流体衰减反转恢复（SUPR-FLAIR）分析，一种新的方法，主要是为了揭示皮质区与微妙的信号hypertensitive.METHODS：图像从101名健康对照组和10名患者患有耐药性部分癫痫进行了回顾性后处理。通过三维（3D）T1加权快速场回波（T1 W-FFE）磁共振成像（MRI）扫描重建脑表面。将快速自旋回波液体衰减反转恢复轴向扫描与3D T1 W-FFE扫描配准，并将其强度值标准化。将皮质强度信号投射到大脑表面，并进行基于表面的分析，将每个患者与101名对照进行比较。比较第一个阳性低P值簇（PLPC）峰和切除区（RZ）的位置。我们研究了5例局灶性皮质发育不良（其中3例MRI阴性）和5例海马硬化症。结果：SUPR-FLAIR分析定位在所有病例的第一个PLPC峰的RZ。由于所有患者自手术后均无癫痫发作，因此可以假设致痫区（EZ）包含在RZ中。因此，SUPR-FLAIR分析正确对齐的EZ，与100%的sensitivity.CONCLUSIONS：SUPR-FLAIR分析是一种非侵入性的技术，可能有助于EZ的定义，特别是当MRI是阴性的。它的使用可以减少侵入性脑电图的适应症，或者可以提供必要的数据，以完善在最具挑战性的情况下脑内电极植入的策略。
OBJECTIVE: The objective of this pilot retrospective study is to describe the SUrface-PRojected FLuid-Attenuation- Inversion-Recovery (SUPR-FLAIR) analysis, a novel method mainly aimed at revealing cortical areas with subtle signal hyperintensity.METHODS: Images from 101 healthy controls and 10 patients suffering from drug-resistant partial epilepsy were retrospectively postprocessed. The brain surface was reconstructed from a 3-dimensional (3D) T1-weighted fast field echo (T1W-FFE) magnetic resonance imaging (MRI) scan. A turbo spin echo fluid attenuated inversion recovery axial scan was registered to the 3D T1W-FFE scan, and its intensity values were normalized. The cortical intensity signal was projected onto the brain surface, and surface-based analysis was performed, comparing each patient against the 101 controls. The localizations of the first positive lower P value cluster (PLPC) peak and the resection zone (RZ) were compared. We studied 5 patients with focal cortical dysplasia (3 of them with negative MRI) and 5 with hippocampal sclerosis.RESULTS: SUPR-FLAIR analysis localized the first PLPC peak in the RZ in all cases. Because all patients have been seizure free since surgery, it can be assumed that the epileptogenic zone (EZ) was included in the RZ. Therefore, SUPR-FLAIR analysis correctly aligned with the EZ, with 100% sensitivity.CONCLUSIONS: SUPR-FLAIR analysis is a noninvasive technique that could be helpful for the definition of the EZ, especially when MRI is negative. Its use could reduce the indications for invasive electroencephalography or could provide essential data to refine the strategy of intracerebral electrode implantation in the most challenging cases.