In vivo 9.4 Tesla MRI of a patient with drug-resistant epilepsy: Technical report

IF 1.9 3区医学 Q3 CLINICAL NEUROLOGY

Acta Neurochirurgica Pub Date : 2025-01-16 DOI:10.1007/s00701-024-06385-4

Rick H. G. J. van Lanen, Daniel Uher, Desmond H. Y. Tse, Esther Steijvers, Albert J. Colon, Jacobus F. A. Jansen, Gerhard S. Drenthen, Dimo Ivanov, Govert Hoogland, Kim Rijkers, Christianne M. Hoeberigs, Paul A. M. Hofman, Walter H. Backes, Olaf E. M. G. Schijns

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引用次数: 0

Abstract

Purpose

In resective epilepsy surgery for drug-resistant focal epilepsy (DRE), good seizure outcome is strongly associated with visualization of an epileptogenic lesion on MRI. Standard clinical MRI (≤ 3 Tesla (T)) may fail to detect subtle lesions. 7T MRI enhances detection and delineation, the potential benefits of increasing field strength to 9.4T are explored.

Methods

A 36 years old male patient with DRE evaluated for resective surgery, in which 3T and 7T MRI failed to detect any epileptogenic lesions, was submitted to a dedicated epilepsy scan protocol using T1 and T2* weighted imaging at 9.4T. Images were evaluated independently by two neuroradiologists and one neurosurgeon.

Results

9.4T MRI offered increased spatial resolution and enhanced depiction of anatomical structures vital for epilepsy imaging, exemplified by regions mesio-temporal (hippocampus, amygdala), latero-temporal, insula, frontal and temporal operculum, and gray-white matter junction (precentral gyrus/frontal lobe) compared to 3T and 7T, albeit with challenges in mesial-temporal and antero-inferior temporal lobe imaging. No epileptogenic lesion was identified.

Conclusion

9.4T demonstrates promise in the identification and delineation of anatomical structures and small epileptogenic lesions in patients with DRE eligible for resective surgery. Whether clinical 9.4T MRI in DRE has clinical advantages over 7T or leads to a more complete resection of the epileptogenic zone and improved seizure outcome after epilepsy surgery needs to be established.

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1例耐药癫痫患者体内9.4特斯拉MRI：技术报告

目的：在抗药局灶性癫痫（drug-resistant局灶性癫痫，DRE）的切除性癫痫手术中，良好的癫痫发作结果与MRI显示的致痫性病变密切相关。标准的临床MRI（≤3特斯拉(T)）可能无法检测到细微病变。7T MRI增强了检测和描绘，探讨了将场强提高到9.4T的潜在好处。方法1例36岁男性DRE患者行切除手术，3T和7T MRI未检出任何癫痫性病变，采用T1和T2*加权成像9.4T进行癫痫专用扫描方案。结果与3T和7T相比，9.4 t MRI提高了空间分辨率，增强了对癫痫成像至关重要的解剖结构的描绘，例如中颞叶（海马、杏仁核）、颞叶外侧、脑岛、额叶和颞叶盖、灰质交界区（中央前回/额叶）。尽管在中颞叶和前下颞叶成像方面存在挑战。结论9.4 t在符合切除手术条件的DRE患者的解剖结构和小的癫痫性病变的识别和描绘方面显示出前景。临床9.4T MRI在DRE中是否比7T有临床优势，或者是否能更完整地切除癫痫区，改善癫痫手术后的发作结局，还有待证实。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Neurochirurgica 医学-临床神经学

CiteScore

4.40

自引率

4.20%

发文量

342

审稿时长

1 months

期刊介绍： The journal "Acta Neurochirurgica" publishes only original papers useful both to research and clinical work. Papers should deal with clinical neurosurgery - diagnosis and diagnostic techniques, operative surgery and results, postoperative treatment - or with research work in neuroscience if the underlying questions or the results are of neurosurgical interest. Reports on congresses are given in brief accounts. As official organ of the European Association of Neurosurgical Societies the journal publishes all announcements of the E.A.N.S. and reports on the activities of its member societies. Only contributions written in English will be accepted.