PDF(Pubmed)
Abstract：
OBJECTIVE: Recently, the 7 Tesla (7 T) Epilepsy Task Force published recommendations for 7 T magnetic resonance imaging (MRI) in patients with pharmaco-resistant focal epilepsy in pre-surgical evaluation. The objective of this study was to implement and evaluate this consensus protocol with respect to both its practicability and its diagnostic value/potential lesion delineation surplus effect over 3 T MRI in the pre-surgical work-up of patients with pharmaco-resistant focal onset epilepsy.
METHODS: The 7 T MRI protocol consisted of T1-weighted, T2-weighted, high-resolution-coronal T2-weighted, fluid-suppressed, fluid-and-white-matter-suppressed, and susceptibility-weighted imaging, with an overall duration of 50 min. Two neuroradiologists independently evaluated the ability of lesion identification, the detection confidence for these identified lesions, and the lesion border delineation at 7 T compared to 3 T MRI.
RESULTS: Of 41 recruited patients > 12 years of age, 38 were successfully measured and analyzed. Mean detection confidence scores were non-significantly higher at 7 T (1.95 ± 0.84 out of 3 versus 1.64 ± 1.19 out of 3 at 3 T, p = 0.050). In 50% of epilepsy patients measured at 7 T, additional findings compared to 3 T MRI were observed. Furthermore, we found improved border delineation at 7 T in 88% of patients with 3 T-visible lesions. In 19% of 3 T MR-negative cases a new potential epileptogenic lesion was detected at 7 T.
CONCLUSIONS: The diagnostic yield was beneficial, but with 19% new 7 T over 3 T findings, not major. Our evaluation revealed epilepsy outcomes worse than ILAE Class 1 in two out of the four operated cases with new 7 T findings.
METHODS: The 7 T MRI protocol consisted of T1-weighted, T2-weighted, high-resolution-coronal T2-weighted, fluid-suppressed, fluid-and-white-matter-suppressed, and susceptibility-weighted imaging, with an overall duration of 50 min. Two neuroradiologists independently evaluated the ability of lesion identification, the detection confidence for these identified lesions, and the lesion border delineation at 7 T compared to 3 T MRI.
RESULTS: Of 41 recruited patients > 12 years of age, 38 were successfully measured and analyzed. Mean detection confidence scores were non-significantly higher at 7 T (1.95 ± 0.84 out of 3 versus 1.64 ± 1.19 out of 3 at 3 T, p = 0.050). In 50% of epilepsy patients measured at 7 T, additional findings compared to 3 T MRI were observed. Furthermore, we found improved border delineation at 7 T in 88% of patients with 3 T-visible lesions. In 19% of 3 T MR-negative cases a new potential epileptogenic lesion was detected at 7 T.
CONCLUSIONS: The diagnostic yield was beneficial, but with 19% new 7 T over 3 T findings, not major. Our evaluation revealed epilepsy outcomes worse than ILAE Class 1 in two out of the four operated cases with new 7 T findings.
摘要：
目标：最近，7Tesla(7T)癫痫专责小组公布了对耐药局灶性癫痫患者进行7T磁共振成像(MRI)术前评估的建议.这项研究的目的是在药物耐药性局灶性发作的患者的术前检查中实施和评估该共识方案的实用性和诊断价值/潜在的病变勾画对3TMRI的剩余作用癫痫发作。
方法：7TMRI方案包括T1加权，T2加权，高分辨率冠状T2加权，流体抑制，流体和白质抑制，和磁敏感加权成像，总持续时间为50分钟。两名神经放射科医生独立评估病变识别的能力，这些已识别病变的检测置信度，与3TMRI相比，7T时的病变边界勾画。
结果：在41名年龄>12岁的患者中，38个被成功地测量和分析。在7T时，平均检测置信度得分没有显着提高（在3T时，3个中的1.95±0.84与3个中的1.64±1.19，p=0.050)。在50％的癫痫患者中，在7T测量，与3TMRI相比,我们观察到了其他发现.此外，我们发现88%的3个T可见病变患者在7T时的边界勾画得到改善.在19％的3TMR阴性病例中，在7T时检测到新的潜在癫痫性病变。
结论：诊断结果是有益的，但有19%新的7吨比3吨的发现，不是主要的。我们的评估显示，在四个手术病例中，有两个有新的7T发现，癫痫的结局比ILAE1级差。
方法：7TMRI方案包括T1加权，T2加权，高分辨率冠状T2加权，流体抑制，流体和白质抑制，和磁敏感加权成像，总持续时间为50分钟。两名神经放射科医生独立评估病变识别的能力，这些已识别病变的检测置信度，与3TMRI相比，7T时的病变边界勾画。
结果：在41名年龄>12岁的患者中，38个被成功地测量和分析。在7T时，平均检测置信度得分没有显着提高（在3T时，3个中的1.95±0.84与3个中的1.64±1.19，p=0.050)。在50％的癫痫患者中，在7T测量，与3TMRI相比,我们观察到了其他发现.此外，我们发现88%的3个T可见病变患者在7T时的边界勾画得到改善.在19％的3TMR阴性病例中，在7T时检测到新的潜在癫痫性病变。
结论：诊断结果是有益的，但有19%新的7吨比3吨的发现，不是主要的。我们的评估显示，在四个手术病例中，有两个有新的7T发现，癫痫的结局比ILAE1级差。
