Value of 7T MRI and post-processing in patients with nonlesional 3T MRI undergoing epilepsy presurgical evaluation.
7T
MRI
focal cortical dysplasia
nonlesional
presurgical evaluation
ultra-high field
Journal
Epilepsia
ISSN: 1528-1167
Titre abrégé: Epilepsia
Pays: United States
ID NLM: 2983306R
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
received:
14
05
2020
revised:
27
07
2020
accepted:
12
08
2020
pubmed:
20
9
2020
medline:
4
2
2021
entrez:
19
9
2020
Statut:
ppublish
Résumé
Ultra-high-field 7-Tesla (7T) magnetic resonance imaging (MRI) offers increased signal-to-noise and contrast-to-noise ratios, which may improve visualization of cortical malformations. We aim to assess the clinical value of in vivo structural 7T MRI and its post-processing for the noninvasive identification of epileptic brain lesions in patients with pharmacoresistant epilepsy and nonlesional 3T MRI who are undergoing presurgical evaluation. Sixty-seven patients were included who had nonlesional 3T MRI by official radiology report. Epilepsy protocols were used for the 3T and 7T acquisitions. Post-processing of the 7T T1-weighted magnetization-prepared two rapid acquisition gradient echoes sequence was performed using the morphometric analysis program (MAP) with comparison to a normal database consisting of 50 healthy controls. Review of 7T was performed by an experienced board-certified neuroradiologist and at the multimodal patient management conference. The clinical significance of 7T findings was assessed based on intracranial electroencephalography (ICEEG) ictal onset, surgery, postoperative seizure outcomes, and histopathology. Unaided visual review of 7T detected previously unappreciated subtle lesions in 22% (15/67). When aided by 7T MAP, the total yield increased to 43% (29/67). The location of the 7T-identified lesion was identical to or contained within the ICEEG ictal onset in 13 of 16 (81%). Complete resection of the 7T-identified lesion was associated with seizure freedom (P = .03). Histopathology of the 7T-identified lesions encountered mainly focal cortical dysplasia (FCD). 7T MAP yielded 25% more lesions (6/24) than 3T MAP, and showed improved conspicuity in 46% (11/24). Our data suggest a major benefit of 7T with post-processing for detecting subtle FCD lesions for patients with pharmacoresistant epilepsy and nonlesional 3T MRI.
Identifiants
pubmed: 32949471
doi: 10.1111/epi.16682
pmc: PMC7722133
mid: NIHMS1630093
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2509-2520Subventions
Organisme : NINDS NIH HHS
ID : R01 NS109439
Pays : United States
Organisme : JoshProvides Epilepsy Assistance Foundation Research
Pays : International
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2020 International League Against Epilepsy.
Références
Epilepsia. 2001 Feb;42(2):282-6
pubmed: 11240604
Neuroimage. 2010 Jan 15;49(2):1271-81
pubmed: 19819338
Epilepsia. 2008 May;49(5):772-85
pubmed: 18047585
Brain. 2011 Oct;134(Pt 10):2844-54
pubmed: 21893591
Epilepsia. 2016 Mar;57(3):348-58
pubmed: 26839983
Ann Neurol. 2015 Jun;77(6):1060-75
pubmed: 25807928
Brain. 2016 Nov 1;139(11):2935-2947
pubmed: 27567464
Rev Neurol (Paris). 2019 Mar;175(3):157-162
pubmed: 30827579
Invest Radiol. 2016 Aug;51(8):469-82
pubmed: 26863580
Nat Rev Neurol. 2011 Feb;7(2):99-108
pubmed: 21243016
Epilepsia. 2002 Jan;43(1):27-32
pubmed: 11879383
N Engl J Med. 2017 Oct 26;377(17):1648-1656
pubmed: 29069555
Neurology. 2014 Jul 1;83(1):48-55
pubmed: 24898923
Epilepsia. 2006 Jan;47(1):134-42
pubmed: 16417541
Eur J Neurol. 2019 Jul;26(7):969-e71
pubmed: 30685877
Epilepsia. 2016 Mar;57(3):445-54
pubmed: 26778405
Ann Neurol. 2016 Jan;79(1):42-58
pubmed: 26448158
Epilepsy Behav. 2019 Feb;91:68-74
pubmed: 30061008
Seizure. 2018 Jan;54:11-18
pubmed: 29172093
Neurology. 2010 Dec 14;75(24):2168-75
pubmed: 21172840
Epilepsia. 2012 Oct;53(10):1731-8
pubmed: 22958128
Neuropathol Appl Neurobiol. 2018 Feb;44(1):18-31
pubmed: 29359399
Brain. 1995 Aug;118 ( Pt 4):1039-50
pubmed: 7655880
Epileptic Disord. 2019 Feb 1;21(1):65-77
pubmed: 30782578
Epilepsy Res. 2005 Oct-Nov;67(1-2):35-50
pubmed: 16171974
J Neuroimaging. 2018 Jul;28(4):365-369
pubmed: 29797439
Epilepsia. 2011 Jan;52(1):158-74
pubmed: 21219302
PLoS One. 2019 Mar 19;14(3):e0213642
pubmed: 30889199
AJR Am J Roentgenol. 2008 Sep;191(3):890-5
pubmed: 18716125
Epileptic Disord. 2020 Apr 1;22(2):156-164
pubmed: 32310136
Epilepsy Res. 2013 Oct;106(3):403-9
pubmed: 23891304
Epilepsia. 2006 May;47(5):908-15
pubmed: 16686656
Neuroimage. 2006 Sep;32(3):1070-9
pubmed: 16872843
Epilepsia Open. 2017 Feb 10;2(2):162-171
pubmed: 29588945
Epileptic Disord. 2016 Sep 1;18(3):315-23
pubmed: 27435411
Brain Pathol. 2017 Jan;27(1):26-35
pubmed: 26748554
Acta Neurol Belg. 2016 Sep;116(3):259-69
pubmed: 27389578
Ann Neurol. 2014 May;75(5):759-70
pubmed: 24777960
Epilepsia. 2011 Jul;52 Suppl 4:10-4
pubmed: 21732934
Epilepsy Res. 2018 Feb;140:184-191
pubmed: 29414526
Epilepsia. 2018 May;59(5):982-992
pubmed: 29637549
PLoS One. 2017 Aug 21;12(8):e0183562
pubmed: 28827835
Ann Neurol. 2001 Jun;49(6):770-5
pubmed: 11409429
Neurology. 2005 Oct 11;65(7):1026-31
pubmed: 16217054