Abstract
In 11 adult patients with suspicion of Focal cortical dysplasia (FCD) on 1.5 T (n = 1) or 3 T (n = 10) magnetic resonance imaging (MRI), 7 T MRI was performed. Visibility, extent, morphological features and delineation were independently rated and subsequently discussed by three observers. Additionally, head-to-head comparisons with corresponding 3 T images were made in the eight patients with a previous 3 T MRI and sustained suspicion of FCD. Comparison with histopathology was done in the five patients that underwent surgery. All lesions, seen at 1.5 and 3 T, were also recognized on 7 T. At 7 T FLAIR highlighted the FCD-like lesions best, whereas T2 and T2* were deemed better suited to review structure and extent of the lesion. Image quality with the used 7 T MRI setup was higher than the quality with the used 3 T MRI setup. In 2 out of 11 patients diagnosis changed, in one after re-evaluation of the images, and in the other based on histopathology. With the used 7 T MRI setup, FCD-like lesions can be detected with more confidence and detail as compared to lower field strength. However, concordance between radiologic diagnosis and final diagnosis seems to be lower than expected.Electronic supplementary materialThe online version of this article (doi:10.1007/s13760-016-0662-x) contains supplementary material, which is available to authorized users.
Highlights
Electronic supplementary material The online version of this article contains supplementary material, which is available to authorized users.Academic Center for Epileptology Kempenhaeghe, Maastricht Universitair Medisch Centrum ? (MUMC?), Sterkselseweg 65, 5590 VE Heeze, The NetherlandsDepartment of Radiology, Leiden University Medical Centre, Leiden, The NetherlandsDepartment of Neurology, University Hospital Gent, Ghent, Belgium20–40 % of epilepsy patients are drug resistant
With the used 7 T magnetic resonance imaging (MRI) setup, Focal cortical dysplasia (FCD)-like lesions can be detected with more confidence and detail as compared to lower field strength
In none of the patients abnormalities were found on 7 T MRI that were not observed at lower field strength and all lesions visible at lower field strength were visible at 7 T
Summary
20–40 % of epilepsy patients are drug resistant. In this group resective surgery, if possible, is the treatment of choice [1, 2]. Finding a lesion on magnetic resonance imaging (MRI) is of clinical importance, as presence of a lesion is associated with a higher chance of developing drug resistant (refractory) epilepsy [3] and increased success rate of surgery [4,5,6]. Sensitivity of MRI for brain lesions partly depends on the system’s magnetic field strength [7,8,9,10,11,12]. Most studies in epilepsy patients have been performed using 1.5 and 3 T MRI systems.
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