The role of the radiologist in order to achieve a better prognosis for epilepsy patients

Congress:

ECR 2020

Poster Number:

C-15116

Type:

Educational Exhibit

Keywords:

Neuro, Neuroradiology brain, MR, MR-Diffusion/Perfusion, MR-Functional imaging, Diagnostic procedure, Seizure disorders, Not applicable

Authors:

J. M. Felices Farias¹, M. Tovar-Perez², I. CASES SUSARTE², F. Barqueros-Escuer², R. Sanchez-Jimenez², C. Serrano-Garcia², D. San Leandro-Pardo², A. Gilabert-Ubeda²; ¹El Palmar, Murcia/ES, ²Murcia/ES

DOI:

10.26044/ecr2020/C-15116

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-15116

Fig. 1: Mesial temporal sclerosis in T1WI showing loss of volume (atrophy) of the left...

Fig. 2: Mesial temporal sclerosis T2WI showing atrophy of left hippocampus and...

Fig. 3: Mesial temporal sclerosis FLAIR showing hyperintensity in the hippocampus...

Fig. 4: Mesial temporal sclerosis T1WI and FLAIR showing loss of volume of the right...

Learning objectives

To point the way how a radiologist can contribute to improving epilepsy patients prognosis dueto: Performingthe optimum MRI protocolto achieve a thorough assessment An accurate interpretation oftheMRI findings in diagnosis andmarking off the epileptogenic focus

Background

THE ROLE OF THE RADIOLOGIST Epilepsy etiology is wide-ranged and must be assessed by radiological studies in order to plan a suitable treatment. Not all epilepsy etiologies respond to pharmacologic treatment so surgery could be required. Surgery success is directly related to removing the epileptogenic area. Hence, the role of the radiologist is main in these patients: to perform an MRI protocol with which are obtained the required radiological findings and to properly interpret them looking forward toevaluatingpotential associations that might appearin other organs andprescribing...

Findings and procedure details

MRI IN MESIAL TEMPORAL SCLEROSIS (MTS) (Figs 1-4) It is the most frequent etiology of a structural anomaly that causes resistance to treatment epilepsy. Hence,the hippocampal region must befocused in the MRI protocolwhen assessing epilepsy. 3DT1 images are optimal to identify the hippocampal volume loss/atrophy,main MRI finding in MTS and also to visualize enlargement of the choroidal fissure and of the ipsilateral temporal horn. Other findings in 3DT1 that are less common are the atrophy of ipsilateral fornix and mammillary body. In T2WI images isshown...

Conclusion

Clinical features in epileptic seizures are non-specific so the radiological diagnosis is crucial to set the suitable treatment. MRI findings might be subtle or very similar between the different diagnostic possibilities. Therefore, the radiologist must clearly understand the pathogeny in order to adequately interpret the image findings and reach a certain diagnosis.

Personal information and conflict of interest

J. M. Felices Farias;C. Serrano-Garcia; R. Sanchez-Jimenez; M. Tovar-Perez;I. Cases-Susarte; F. Barqueros-Escuer; D. San Leandro-Pardo; A. Gilabert-Ubeda All authors at Hospital Clinico Universitario Virgen de la Arrixaca Murcia/ES

References

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