COMPARISION OF QUANTITATIVE AND QUALITITATIVE ASSESSMENT OF MRI IN DIAGNOSING HIPOCAMPAL ATROPHY AMONG CASES OF TEMPORAL EPILEPSY.

Abstract

Mesial temporal sclerosis (MTS) is the most common pathology in patients undergoing anterior temporal lobectomy. Magnetic resonance imaging (MRI) is valuable in detecting MTS. Reduced hippocampal volume and elevated T2 signal are associated with MTS, and both quantitative T2 and volumetric measurements
have been associated with hippocampal cellular loss that characterizes this condition. Objectives: To determine the accuracy of hippocampal quantitative (T2 relaxometric) assessment in diagnosing hippocampal atrophy in patients with temporal lobe epilepsy by comparing it with qualitative (visual) assessment on MRI. Study Design: Cross sectional study. Setting: Radiology department of Allied Hospital Faisalabad. Period: 12 months from the
approval from Sep, 2016 to Dec, 2017. Subjects & Methods: After taking permission from hospital ethical committee, and written informed consent, patients with history of temporal lobe epilepsy and EEG findings consistent with temporal lobe epilepsy were examined on 1.5 Tesla Achieva philips scanner, visual assessment and T2 relaxometry. Section of the hippocampus head was defined as the first in which it was possible to see the temporal horn of the lateral ventricle and therefore to appropriately separate the hippocampal formation from the amygdala. The body of the hippocampus defined in the fourth coronal section after the region of interest of the hippocampus head, and the tail was defined in the third coronal section after the hippocampus body, in which it is also possible to visualize the quadrigeminal plate (section of 5mm).Visually the images were assessed and MRI examination was done. All the data was collected on a performa. Results: We concluded that the frequency of accuracy of hippocampal quantitative (t2 relaxometric) assessment in diagnosing hippocampal atrophy in patients with temporal lobe epilepsy by comparing it with qualitative (visual) assessment on MRI
is high but needs validation through some-other studies. Conclusion: We concluded that the frequency of accuracy of hippocampal quantitative (t2 relaxometric) assessment in diagnosing hippocampal atrophy in patients with temporal lobe epilepsy by comparing it with qualitative (visual) assessment on MRI is high but needs validation through some-other studies.