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IF 2.4 3区医学 Q2 CLINICAL NEUROLOGY

Neuroradiology Pub Date : 2025-03-05 DOI:10.1007/s00234-025-03549-6

Francesca De Luca, Jose Carlos Pariente, Sofia González-Ortiz, Estefanía Conde-Blanco, Mar Carreño, Xavier Setoain, Nuria Bargalló

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引用次数: 0

摘要

目的：本研究比较了两个主要针对局灶性皮质发育不良（FCD）设计的图像后处理工具箱：多中心癫痫病灶检测（MELD）和形态计量分析程序（MAP18）在核磁共振成像上识别颞叶癫痫（TLE）结构病灶的能力：这项回顾性研究对79名成年人进行了检查，其中58人为确诊的TLE患者，21人为健康对照组。所有参与者均于 2007 年 6 月至 2023 年 5 月期间在西班牙巴塞罗那的医院诊所接受了选择性脑磁共振成像检查。所有三维 T1 加权图像均使用 MELD 和 MAP18 进行处理，以检测潜在的致痫病灶。参考 TLE 结构性病变（refTLE）的位置（外侧或内侧）和侧向是通过组织病理学或基于临床数据的多学科共识确定的。使用描述性统计、特异性和诊断准确性对工具箱的性能进行评估。此外，如果 MELD 和 MAP18 检测出的异常与 refTLE 不匹配，则对病例进行二次 MRI 检查：结果：MELD 和 MAP18 的特异性和诊断准确性存在差异。特异性从 48% 到 86% 不等，ProbMAP（MAP18）的特异性值最高。总体诊断准确率从 7% 到 42% 不等，其中 MELD 的诊断准确率最高。在核磁共振成像上有明显致痫病灶的四名患者中，MELD 和 MAP18 发现了之前被忽视的其他异常。此外，MELD还在一名最初被归类为MRI阴性（非病变）的患者中发现了一个TLE病灶：结论：将 MELD 和 MAP18 等工具纳入诊断工作流程可提高 MRI 对 TLE 相关异常的检出率，从而改善患者预后并帮助临床决策。

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Potential role of MELD and MAP18 in patients with structural temporal lobe epilepsy.

Purpose: This study compared two image post-processing toolboxes primarily designed for focal cortical dysplasia (FCD): Multi-Centre Epilepsy Lesion Detection (MELD) and Morphometric Analysis Program (MAP18), in identifying temporal lobe epilepsy (TLE) structural lesions on MRI.

Methods: This retrospective study examined 79 adults, 58 patients with confirmed TLE, and 21 healthy controls. All participants underwent an elective brain MRI between June 2007 - May 2023 at Hospital Clinic, Barcelona, Spain. All the 3D T1-weighted images were processed using MELD and MAP18 to detect potential epileptogenic lesions. The location (lateral or mesial) and laterality of the reference TLE structural lesion (refTLE) were determined through histopathology or multidisciplinary consensus based on clinical data. Toolboxes' performance was evaluated using descriptive statistics, specificity, and diagnostic accuracy. Additionally, a second-look MRI was conducted for cases where abnormalities detected by MELD and MAP18 did not match the refTLE.

Results: MELD and MAP18 demonstrated variability in specificity and diagnostic accuracy. Specificity ranged from 48% to 86%, with ProbMAP (MAP18) achieving the highest values. Global diagnostic accuracy ranged from 7% to 42%, with MELD showing the highest performance. In four patients with visible epileptogenic lesions on MRI, MELD and MAP18 identified additional abnormalities that were previously overlooked. Moreover, MELD detected one TLE lesion in one patient initially classified as MRI-negative (nonlesional).

Conclusion: Incorporating tools like MELD and MAP18 into the diagnostic workflow can enhance the detection of TLE-related abnormalities on MRI, potentially improving patient outcomes and aiding in clinical decision-making.

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来源期刊

Neuroradiology 医学-核医学

CiteScore

5.30

自引率

3.60%

发文量

214

审稿时长

4-8 weeks

期刊介绍： Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.