早期MRI在预测发热性癫痫持续状态儿童海马硬化风险中的作用。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie Pub Date : 2025-05-01 DOI:10.1016/j.arcped.2024.12.007

Rose Germain , Mathilde Le Floch , Marine Dubois , Pauline Cloarec , Raphaël Chouteau , Bertrand Bruneau

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引用次数: 0

摘要

背景：癫痫是儿童发热性癫痫持续状态（FSE）的主要并发症。FSE与海马硬化（HS）和内侧颞叶癫痫（MTLE）的发展之间的关系是有争议的。目的：本研究主要旨在评价FSE急性期磁共振成像（MRI）弥散加权成像（DWI）序列在预测HS和癫痫长期发展中的作用。次要目的是评估动脉自旋标记（ASL）灌注MRI在FSE急性期的价值。方法和背景：回顾性纳入6个月至5岁之间首次发作的FSE患者，并进行早期MRI检查。MRI分析主要集中在ASL成像的DWI信号和灌注异常的存在。我们还检查了急性期的第一次脑电图（EEG）。长期随访分析评估HS在MRI扫描上的发生和癫痫的发展。结果：共纳入15例患儿。在FSE后急性期mri上出现的受限扩散区与HS的后期发展显著相关。然而，在随访中发现的3例患者中，早期mri上受限扩散区域与耐药癫痫的发展之间的相关性无统计学意义。早期ASL灌注MRI变化与脑电图结果有密切联系的趋势。结论：早期DWI-MRI似乎在儿童FSE的预后评估中起着重要作用。它可能有助于确定海马受累和评估随后HS的风险。然而，研究数据不足以得出弥散异常与MTLE发展之间的关系。虽然ASL灌注可能提供额外的见解，但需要更多的数据。

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Role of early MRI in predicting the risk of hippocampal sclerosis in children with febrile status epilepticus

Background

Epilepsy is the main complication of febrile status epilepticus (FSE) in children. The association between FSE and the development of hippocampal sclerosis (HS) and mesial temporal lobe epilepsy (MTLE) is controversial.

Objectives

This study primarily aimed to evaluate the role of magnetic resonance imaging (MRI) in diffusion-weighted imaging (DWI) sequence during the acute phase of FSE in predicting long-term development of HS and epilepsy. The secondary objective was to assess the value of arterial spin labeling (ASL) perfusion MRI in the acute phase of FSE.

Methods and settings

Patients with a first episode of FSE between 6 months and 5 years of age who underwent early MRI were retrospectively included. MRI analysis focused on the DWI signal and the presence of perfusion abnormalities on ASL imaging. We also examined the first electroencephalogram (EEG) during the acute phase. Long-term follow-up analysis assessed the occurrence of HS on MRI scans and the development of epilepsy.

Results

A total of 15 children were included. The presence of restricted diffusion areas on MRIs performed in the acute phase after FSE was significantly associated with the later development of HS. However, the association between restricted diffusion areas on early MRIs and the development of pharmaco-resistant epilepsy on follow-up, found in 3 patients, was not statistically significant. There was a trend for an association between early ASL perfusion MRI changes and EEG findings when both examinations were performed closely.

Conclusion

Early DWI-MRI seems to play a major role in the prognostic evaluation of FSE in children. It may help to determine hippocampal involvement and assess the risk of subsequent HS. However, the study data are insufficient to conclude on the association between diffusion abnormalities and the development of MTLE. Although ASL perfusion may provide additional insight, more data are needed.

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来源期刊

Archives De Pediatrie 医学-小儿科

CiteScore

2.80

自引率

5.60%

发文量

106

审稿时长

24.1 weeks

期刊介绍： Archives de Pédiatrie publishes in English original Research papers, Review articles, Short communications, Practice guidelines, Editorials and Letters in all fields relevant to pediatrics. Eight issues of Archives de Pédiatrie are released annually, as well as supplementary and special editions to complete these regular issues. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. Archives de Pédiatrie is the official publication of the French Society of Pediatrics.