Abstract
With a major role in revealing epileptogenic lesions, magnetic resonance imaging (MRI) has also been very helpful in surgical planning and postoperative follow-up of drug-resistant focal epilepsies. In this article, in addition to discussing the most common epileptogenic lesions, advanced quantitative and functional MRI techniques in detecting abnormalities and revealing hemodynamic and microstructural changes are emphasized.
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Abbreviations
- ASL:
-
Arterial spin labeling
- AVM:
-
Arteriovenous malformation
- BOLD:
-
Blood oxygen level-dependent
- CT:
-
Computed tomography
- DNET:
-
Dysembryoplastic neuroepithelial tumor
- DTI:
-
Diffusion-tensor imaging
- DWI:
-
Diffusion-weighted imaging
- ECS:
-
Electrocortical stimulation
- EEG:
-
Electroencephalogram
- FCD:
-
Focal cortical dysplasia
- FLAIR:
-
Fluid-attenuated inversion recovery
- fMRI:
-
Functional magnetic resonance imaging
- Gd:
-
Gadolinium
- GM:
-
Gray matter
- HS:
-
Hippocampal sclerosis
- IR:
-
Inversion recovery
- LGA:
-
Low-grade astrocytoma
- MCD:
-
Malformation of cortical development
- MPRAGE:
-
Magnetization-prepared gradient-recalled echo
- MRI:
-
Magnetic resonance imaging
- MRS:
-
Magnetic resonance spectroscopy
- MTC:
-
Magnetization-transfer contrast
- MTS:
-
Mesial temporal sclerosis
- PET:
-
Fluorodeoxyglucose (FDG) positron emission tomography
- PWI:
-
Perfusion-weighted MR imaging
- PXA:
-
Pleomorphic xanthoastrocytoma
- SE:
-
Status epilepticus
- SNR:
-
Signal-to-noise ratio
- SPECT:
-
Single photon emission CT
- SPGR:
-
Spoiled gradient echo
- SWI:
-
Susceptibility-weighted imaging
- TLE:
-
Temporal lobe epilepsy
- TSC:
-
Tuberous sclerosis
- VBM:
-
Voxel-based morphometry
- WM:
-
White matter
References
Anderson DP, Harvey AS, Saling MM, Anderson V, Kean M, Abbott DF, Wellard RM, Jackson GD (2006) FMRI lateralization of expressive language in children with cerebral lesions. Epilepsia 47(6):998–1008
Ashburner J, Friston KJ (2000) Voxel-based morphometry – the methods. Neuroimage 11(6 Pt 1):805–821
Atlas SW (2009) Magnetic resonance imaging of the brain and spine, 4th edn. Lippincott Williams & Wilkins, Philadelphia, pp 312–313
Baron Y, Barkovich AJ (1999) MR imaging of tuberous sclerosis in neonates and young infants. AJNR Am J Neuroradiol 20(5):907–916
Bargalló N (2008) Functional magnetic resonance: new applications in epilepsy. Eur J Radiol 67(3):401–408
Bastos AC, Comeau RM, Andermann F, Melanson D, Cendes F, Dubeau F, Fontaine S, Tampieri D, Olivier A (1999) Diagnosis of subtle focal dysplastic lesions: curvilinear reformatting from three-dimensional magnetic resonance imaging. Ann Neurol 46(1):88–94
Benifla M, Otsubo H, Ochi A, Weiss SK, Donner EJ, Shroff M, Chuang S, Hawkins C, Drake JM, Elliott I, Smith ML, Snead OC 3rd, Rutka JT (2006) Temporal lobe surgery for intractable epilepsy in children: an analysis of outcomes in 126 children. Neurosurgery 59(6): 1203–1213
Benke T, Köylü B, Visani P, Karner E, Brenneis C, Bartha L, Trinka E, Trieb T, Felber S, Bauer G, Chemelli A, Willmes K (2006) Language lateralization in temporal lobe epilepsy: a comparison between fMRI and the Wada Test. Epilepsia 47(8):1308–1319
Bernasconi A, Bernasconi N, Bernhardt BC, Schrader D (2011) Advances in MRI for ‘cryptogenic’ epilepsies. Nat Rev Neurol 7(2):99–108
Binder JR, Sabsevitz DS, Swanson SJ, Hammeke TA, Raghavan M, Mueller WM (2008) Use of preoperative functional MRI to predict verbal memory decline after temporal lobe epilepsy surgery. Epilepsia 49(8):1377–1394
Blümcke I, Löbach M, Wolf HK, Wiestler OD (1999) Evidence for developmental precursor lesions in epilepsy-associated glioneuronal tumors. Microsc Res Tech 46(1):53–58
Blümcke I, Thom M, Aronica E, Armstrong DD, Vinters HV, Palmini A, Jacques TS, Avanzini G, Barkovich AJ, Battaglia G, Becker A, Cepeda C, Cendes F, Colombo N, Crino P, Cross JH, Delalande O, Dubeau F, Duncan J, Guerrini R, Kahane P, Mathern G, Najm I, Ozkara C, Raybaud C, Represa A, Roper SN, Salamon N, Schulze-Bonhage A, Tassi L, Vezzani A, Spreafico R (2011) The clinicopathologic spectrum of focal cortical dysplasias: a consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission. Epilepsia 52(1):158–174
Bote RP, Blázquez-Llorca L, Fernández-Gil MA, Alonso-Nanclares L, Muñoz A, De Felipe J (2008) Hippocampal sclerosis: histopathology substrate and magnetic resonance imaging. Semin Ultrasound CT MR 29(1):2–14
Bronen RA, Cheung G, Charles JT, Kim JH, Spencer DD, Spencer SS, Sze G, McCarthy G (1991) Imaging findings in hippocampal sclerosis: correlation with pathology. AJNR Am J Neuroradiol 12(5):933–940
Bronen RA, Anderson AW, Spencer DD (1994) Quantitative MR for epilepsy: a clinical and research tool? AJNR Am J Neuroradiol 15(6):1157–1160
Campos AR, Clusmann H, von Lehe M, Niehusmann P, Becker AJ, Schramm J, Urbach H (2009) Simple and complex dysembryoplastic neuroepithelial tumors (DNT) variants: clinical profile, MRI, and histopathology. Neuroradiology 51(7):433–443
Cataltepe O, Jallo GI (2010) Pediatric epilepsy surgery: preoperative assessment and surgical intervention, 1st edn. Thieme Medical Publishers, New York, pp 60–61
Cendes F, Cook MJ, Watson C, Andermann F, Fish DR, Shorvon SD, Bergin P, Free S, Dubeau F, Arnold DL (1995) Frequency and characteristics of dual pathology in patients with lesional epilepsy. Neurology 45(11):2058–2064
Cendes F, Li LM, Andermann F, Watson C, Fish DR, Shorvon SD, Dubeau F, Arnold DL (1999) Dual pathology and its clinical relevance. Adv Neurol 81:153–164
Chan S, Erickson JK, Yoon SS (1997) Limbic system abnormalities associated with mesial Âtemporal sclerosis: a model of chronic cerebral changes due to seizures. Radiographics 17(5):1095–1110
Cheon JE, Chang KH, Kim HD, Han MH, Hong SH, Seong SO, Kim IO, Lee SG, Hwang YS, Kim HJ (1998) MR of hippocampal sclerosis: comparison of qualitative and quantitative assessments. AJNR Am J Neuroradiol 19(3):465–468
Colliot O, Bernasconi N, Khalili N, Antel SB, Naessens V, Bernasconi A (2006) Individual voxel-based analysis of gray matter in focal cortical dysplasia. Neuroimage 29(1):162–171
Colombo N, Tassi L, Galli C, Citterio A, Lo Russo G, Scialfa G, Spreafico R (2003) Focal cortical dysplasias: MR imaging, histopathologic, and clinical correlations in surgically treated patients with epilepsy. AJNR Am J Neuroradiol 24(4):724–733
Cook MJ (1994) Mesial temporal sclerosis and volumetric investigations. Acta Neurol Scand Suppl 152:109–114, discussion 115
Crompton DE, Scheffer IE, Taylor I, Cook MJ, McKelvie PA, Vears DF, Lawrence KM, McMahon JM, Grinton BE, McIntosh AM, Berkovic SF (2010) Familial mesial temporal lobe epilepsy: a benign epilepsy syndrome showing complex inheritance. Brain 133(11):3221–3231
Davies KG, Hermann BP, Dohan FC Jr, Foley KT, Bush AJ, Wyler AR (1996) Relationship of hippocampal sclerosis to duration and age of onset of epilepsy, and childhood febrile seizures in temporal lobectomy patients. Epilepsy Res 24(2):119–126
Duchowny M, Jayakar P, Harvey AS, Resnick T, Alvarez L, Dean P, Levin B (1996) Language cortex representation: effects of developmental versus acquired pathology. Ann Neurol 40(1):31–38
Dumas de la Roque A, Oppenheim C, Chassoux F, Rodrigo S, Beuvon F, Daumas-Duport C, Devaux B, Meder JF (2005) Diffusion tensor imaging of partial intractable epilepsy. Eur Radiol 15(2):279–285
Dym RJ, Burns J, Freeman K, Lipton ML (2011) Is functional MR imaging assessment of hemispheric language dominance as good as the Wada test? A meta-analysis. Radiology 261:446–455
Fauser S, Bast T, Altenmüller DM, Schulte-Mönting J, Strobl K, Steinhoff BJ, Zentner J, Schulze-Bonhage A (2008) Factors influencing surgical outcome in patients with focal cortical dysplasia. J Neurol Neurosurg Psychiatry 79(1):103–105
Fernandez C, Girard N, Paz Paredes A, Bouvier-Labit C, Lena G, Figarella-Branger D (2003) The usefulness of MR imaging in the diagnosis of dysembryoplastic neuroepithelial tumor in children: a study of 14 cases. AJNR Am J Neuroradiol 24(5):829–834
Giannini C, Scheithauer BW, Burger PC, Brat DJ, Wollan PC, Lach B, O’Neill BP (1999) Pleomorphic xanthoastrocytoma: what do we really know about it? Cancer 85(9):2033–2045
Gross DW (2011) Diffusion tensor imaging in temporal lobe epilepsy. Epilepsia 52(Suppl 4): 32–34
Gotman J (2008) Epileptic networks studied with EEG-fMRI. Epilepsia 49(Suppl 3):42–51
Harkness W (2006) Temporal lobe resections. Childs Nerv Syst 22(8):936–944
Hedera P, Blair MA, Andermann E, Andermann F, D’Agostino D, Taylor KA, Chahine L, Pandolfo M, Bradford Y, Haines JL, Abou-Khalil B (2007) Familial mesial temporal lobe epilepsy maps to chromosome 4q13.2-q21.3. Neurology 68(24):2107–2112
Hirfanoglu T, Gupta A (2010) Tuberous sclerosis complex with a single brain lesion on MRI mimicking focal cortical dysplasia. Pediatr Neurol 42(5):343–347
Ho SS, Kuzniecky RI, Gilliam F, Faught E, Morawetz R (1998) Temporal lobe developmental malformations and epilepsy: dual pathology and bilateral hippocampal abnormalities. Neurology 50(3):748–754
Huang YC, Weng HH, Tsai YT, Huang YC, Hsiao MC, Wu CY, Lin YH, Hsu HL, Lee JD (2009) Periictal magnetic resonance imaging in status epilepticus. Epilepsy Res 86(1):72–81
Huppertz HJ, Kassubek J, Altenmüller DM, Breyer T, Fauser S (2008) Automatic curvilinear reformatting of three-dimensional MRI data of the cerebral cortex. Neuroimage 39(1):80–86
Im SH, Chung CK, Kim SK, Cho BK, Kim MK, Chi JG (2004) Pleomorphic xanthoastrocytoma: a developmental glioneuronal tumor with prominent glioproliferative changes. J Neurooncol 66(1–2):17–27
Katramados AM, Burdette D, Patel SC, Schultz LR, Gaddam S, Mitsias PD (2009) Periictal diffusion abnormalities of the thalamus in partial status epilepticus. Epilepsia 50(2):265–275
Keller SS, Mackay CE, Barrick TR, Wieshmann UC, Howard MA, Roberts N (2002) Voxel-based morphometric comparison of hippocampal and extrahippocampal abnormalities in patients with left and right hippocampal atrophy. Neuroimage 16(1):23–31
Keller SS, Roberts N (2008) Voxel-based morphometry of temporal lobe epilepsy: an introduction and review of the literature. Epilepsia 49(5):741–757
Kim DW, Lee SK, Chu K, Park KI, Lee SY, Lee CH, Chung CK, Choe G, Kim JY (2009) Predictors of surgical outcome and pathologic considerations in focal cortical dysplasia. Neurology 72(3):211–216
Koeller KK, Henry JM (2001) From the archives of the AFIP: superficial gliomas: radiologic-pathologic correlation. Armed Forces Institute of Pathology. Radiographics 21(6):1533–1556
Lach B, Duggal N, DaSilva VF, Benoit BG (1996) Association of pleomorphic xanthoastrocytoma with cortical dysplasia and neuronal tumors. A report of three cases. Cancer 78(12):2551–2563
Lerner JT, Salamon N, Hauptman JS, Velasco TR, Hemb M, Wu JY, Sankar R, Donald Shields W, Engel J Jr, Fried I, Cepeda C, Andre VM, Levine MS, Miyata H, Yong WH, Vinters HV, Mathern GW (2009) Assessment and surgical outcomes for mild type I and severe type II cortical dysplasia: a critical review and the UCLA experience. Epilepsia 50(6):1310–1335
Lin DD, Barker PB, Hatfield LA, Comi AM (2006) Dynamic MR perfusion and proton MR spectroscopic imaging in Sturge-Weber syndrome: correlation with neurological symptoms. J Magn Reson Imaging 24(2):274–281
Luyken C, Blümcke I, Fimmers R, Urbach H, Elger CE, Wiestler OD, Schramm J (2003) The spectrum of long-term epilepsy-associated tumors: long-term seizure and tumor outcome and neurosurgical aspects. Epilepsia 44(6):822–830
Madan N, Grant PE (2009) New directions in clinical imaging of cortical dysplasias. Epilepsia 50(9)
Margerison JH, Corsellis JA (1966) Epilepsy and the temporal lobes. A clinical, electroencephalographic, and neuropathological study of the brain in epilepsy, with particular reference to the temporal lobes. Brain 89:499–530
Meiners LC, van Gils A, Jansen GH, de Kort G, Witkamp TD, Ramos LM, Valk J, Debets RM, van Huffelen AC, van Veelen CW et al (1994) Temporal lobe epilepsy: the various MR appearances of histologically proven mesial temporal sclerosis. AJNR Am J Neuroradiol 15(8):1547–1555
Meiners LC, Witkamp TD, de Kort GA, van Huffelen AC, van der Graaf Y, Jansen GH, van der Grond J, van Veelen CW (1999) Relevance of temporal lobe white matter changes in hippocampal sclerosis. Magnetic resonance imaging and histology. Invest Radiol 34(1):38–45
Mittal S, Wu Z, Neelavalli J, Haacke EM (2009) Susceptibility-weighted imaging: technical aspects and clinical applications, part 2. AJNR Am J Neuroradiol 30(2):232–252
Oguz KK, Senturk S, Ozturk A, Anlar B, Topcu M, Cila A (2007) Impact of recent seizures on cerebral blood flow in patients with Sturge-Weber syndrome: study of 2 cases. J Child Neurol 22(5):617–620
Ozturk A, Oguz KK, Akalan N, Geyik PO, Cila A (2006) Evaluation of parenchymal changes at the operation site with early postoperative brain diffusion-weighted magnetic resonance imaging. Diagn Interv Radiol 12(3):115–120
Palmini A, Najm I, Avanzini G, Babb T, Guerrini R, Foldvary-Schaefer N, Jackson G, Lüders HO, Prayson R, Spreafico R, Vinters HV (2004) Terminology and classification of the cortical dysplasias. Neurology 62(6 Suppl 3):S2–S8
Parmar HA, Hawkins C, Ozelame R, Chuang S, Rutka J, Blaser S (2007) Fluid-attenuated inversion recovery ring sign as a marker of dysembryoplastic neuroepithelial tumors. J Comput Assist Tomogr 31(3):348–353
Provenzale JM, Ali U, Barboriak DP, Kallmes DF, Delong DM, McLendon RE (2000) Comparison of patient age with MR imaging features of gangliogliomas. AJR Am J Roentgenol 174(3):859–862
Sakuta R, Otsubo H, Nolan MA, Weiss SK, Hawkins C, Rutka JT, Chuang NA, Chuang SH, Snead OC (2005) Recurrent intractable seizures in children with cortical dysplasia adjacent to dysembryoplastic neuroepithelial tumor. J Child Neurol 20(4):377–384
Szabo K, Poepel A, Pohlmann-Eden B, Hirsch J, Back T, Sedlaczek O, Hennerici M, Gass A (2003) Use of preoperative functional neuroimaging to predict language deficits from epilepsy surgery. Neurology 60(11):1788–1792
Szabo K, Poepel A, Pohlmann-Eden B, Hirsch J, Back T, Sedlaczek O, Hennerici M, Gass A (2005) Diffusion-weighted and perfusion MRI demonstrates parenchymal changes in complex partial status epilepticus. Brain 128(Pt 6):1369–1376
Szaflarski JP, Holland SK, Jacola LM, Lindsell C, Privitera MD, Szaflarski M (2008) Comprehensive presurgical functional MRI language evaluation in adult patients with epilepsy. Epilepsy Behav 12(1):74–83
Taylor DC, Falconer MA, Bruton CJ, Corsellis JA (1971) Focal dysplasia of the cerebral cortex in epilepsy. J Neurol Neurosurg Psychiatry 34(4):369–387
Urbach H, Scheffler B, Heinrichsmeier T, von Oertzen J, Kral T, Wellmer J, Schramm J, Wiestler OD, Blümcke I (2002) Focal cortical dysplasia of Taylor’s balloon cell type: a clinicopathological entity with characteristic neuroimaging and histopathological features, and favorable postsurgical outcome. Epilepsia 43(1):33–40
VanLandingham KE, Heinz ER, Cavazos JE, Lewis DV (1998) Magnetic resonance imaging evidence of hippocampal injury after prolonged focal febrile convulsions. Ann Neurol 43(4):413–426
Von Oertzen J, Urbach H, Jungbluth S, Kurthen M, Reuber M, Fernández G, Elger CE (2002) Standard magnetic resonance imaging is inadequate for patients with refractory focal epilepsy. J Neurol Neurosurg Psychiatry 73(6):643–647
Widjaja E, Zarei Mahmoodabadi S, Otsubo H, Snead OC, Holowka S, Bells S, Raybaud C (2009) Subcortical alterations in tissue microstructure adjacent to focal cortical dysplasia: detection at diffusion-tensor MR imaging by using magnetoencephalographic dipole cluster localization. Radiology 251(1):206–215
Woermann FG, Jokeit H, Luerding R, Freitag H, Schulz R, Guertler S, Okujava M, Wolf P, Tuxhorn I, Ebner A (2003) Language lateralization by Wada test and fMRI in 100 patients with epilepsy. Neurology 61(5):699–701
Wolf RL, Alsop DC, Levy-Reis I, Meyer PT, Maldjian JA, Gonzalez-Atavales J, French JA, Alavi A, Detre JA (2001) Detection of mesial temporal lobe hypoperfusion in patients with temporal lobe epilepsy by use of arterial spin labeled perfusion MR imaging. AJNR Am J Neuroradiol 22(7):1334–1341
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Oguz, K.K. (2012). Magnetic Resonance Imaging in Epilepsy. In: Akalan, N., Di Rocco, C. (eds) Pediatric Epilepsy Surgery. Advances and Technical Standards in Neurosurgery, vol 39. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1360-8_3
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DOI: https://doi.org/10.1007/978-3-7091-1360-8_3
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