T2 mapping outperforms normalised FLAIR in identifying hippocampal sclerosis

R Rodionov; P A Bartlett; Ci He; S B Vos; N K Focke; S G Ourselin; J S Duncan

doi:10.1016/j.nicl.2015.03.004

T2 mapping outperforms normalised FLAIR in identifying hippocampal sclerosis

Neuroimage Clin. 2015 Mar 13:7:788-91. doi: 10.1016/j.nicl.2015.03.004. eCollection 2015.

Authors

R Rodionov¹, P A Bartlett¹, Ci He², S B Vos³, N K Focke⁴, S G Ourselin⁵, J S Duncan¹

Affiliations

¹ Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK ; MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK.
² Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK ; MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK ; Department of Radiology, Chengdu Military General Hospital, China.
³ Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK ; MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK ; Centre for Medical Image Computing, Translational Imaging Group, University College London, London, UK.
⁴ Department of Neurology and Epileptology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
⁵ Centre for Medical Image Computing, Translational Imaging Group, University College London, London, UK.

Abstract

Rationale: Qualitatively, FLAIR MR imaging is sensitive to the detection of hippocampal sclerosis (HS). Quantitative analysis of T2 maps provides a useful objective measure and increased sensitivity over visual inspection of T2-weighted scans. We aimed to determine whether quantification of normalised FLAIR is as sensitive as T2 mapping in detection of HS.

Method: Dual echo T2 and FLAIR MR images were retrospectively analysed in 27 patients with histologically confirmed HS and increased T2 signal in ipsilateral hippocampus and 14 healthy controls. Regions of interest were manually segmented in all hippocampi aiming to avoid inclusion of CSF. Hippocampal T2 values and measures of normalised FLAIR Signal Intensity (nFSI) were compared in healthy and sclerotic hippocampi.

Results: HS was identified on T2 values with 100% sensitivity and 100% specificity. HS was identified on nFSI measures with 60% sensitivity and 93% specificity.

Conclusion: T2 mapping is superior to nFSI for identification of HS.

Keywords: Hippocampal sclerosis; T2 FLAIR; T2 mapping.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Brain Mapping / methods*
Epilepsy, Temporal Lobe / diagnosis*
Female
Hippocampus / pathology*
Humans
Image Interpretation, Computer-Assisted / methods*
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Sclerosis / pathology
Sensitivity and Specificity
Young Adult