학술논문
Limbic Encephalitis in Patients with Epilepsy-is Quantitative MRI Diagnostic?
Original Article
Original Article
Document Type
Clinical report
Author
Source
Clinical Neuroradiology. December 2019, Vol. 29 Issue 4, p623, 8 p.
Subject
Language
English
ISSN
1869-1439
Abstract
Author(s): Arndt-Hendrik Schievelkamp [sup.1], Alina Jurcoane [sup.1], Theodor Rüber [sup.2], Leon Ernst [sup.2], Andreas Müller [sup.1], Burkhard Mädler [sup.3], Hans Heinz Schild [sup.4], Elke Hattingen [sup.1] Author Affiliations: (1) grid.15090.3d, [...]
Purpose Limbic encephalitis (LE) is an immune-related disease with limbic symptoms, variable and asymmetric magnetic resonance imaging (MRI) aspects and antibody profiles. This study investigated the diagnostic value of quantitative relaxation times T2 (qT2) and MRI signal intensities (SI) in LE. Methods The prospective 3T-MRI study included 39 epilepsy patients with initially suspected LE and 20 healthy controls. Values and asymmetry indices of qT2, T2-weighted (T2-w) and proton density (PD)-w SI of manually delineated and automatically segmented amygdala and hippocampus were measured. Additionally, two raters made a blinded visual analysis on FLAIR (fluid attenuation inversion recovery) and T2-w images. Results According to diagnostic guidelines, 22 patients had probable LE and 17 patients had possible LE. The qT2 was higher (pâ¯< 0.01) in patients than in controls (mean⯱ SD, amygdala 98⯱ 7â¯ms vs. 90⯱ 5â¯ms, hippocampus 101⯱ 7â¯ms vs. 92⯱ 3â¯ms), but was not different between probable and possible LE or between sides (left and right). The PD-w SI and T2-w SI were lower in patients than in controls but were not different between patient subgroups or between sides. Diagnostic performance of visual analysis was relatively poor. Conclusions Epilepsy patients with suspected LE had elevated qT2 in amygdala and hippocampus, whereas the expected T2-w SI increase was not found; however, the diagnostic value of qT2 remains questionable since it did not discriminate probable from possible LE.
Purpose Limbic encephalitis (LE) is an immune-related disease with limbic symptoms, variable and asymmetric magnetic resonance imaging (MRI) aspects and antibody profiles. This study investigated the diagnostic value of quantitative relaxation times T2 (qT2) and MRI signal intensities (SI) in LE. Methods The prospective 3T-MRI study included 39 epilepsy patients with initially suspected LE and 20 healthy controls. Values and asymmetry indices of qT2, T2-weighted (T2-w) and proton density (PD)-w SI of manually delineated and automatically segmented amygdala and hippocampus were measured. Additionally, two raters made a blinded visual analysis on FLAIR (fluid attenuation inversion recovery) and T2-w images. Results According to diagnostic guidelines, 22 patients had probable LE and 17 patients had possible LE. The qT2 was higher (pâ¯< 0.01) in patients than in controls (mean⯱ SD, amygdala 98⯱ 7â¯ms vs. 90⯱ 5â¯ms, hippocampus 101⯱ 7â¯ms vs. 92⯱ 3â¯ms), but was not different between probable and possible LE or between sides (left and right). The PD-w SI and T2-w SI were lower in patients than in controls but were not different between patient subgroups or between sides. Diagnostic performance of visual analysis was relatively poor. Conclusions Epilepsy patients with suspected LE had elevated qT2 in amygdala and hippocampus, whereas the expected T2-w SI increase was not found; however, the diagnostic value of qT2 remains questionable since it did not discriminate probable from possible LE.