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T2 hyperintense signal in patients with temporal lobe epilepsy with MRI signs of hippocampal sclerosis and in patients with temporal lobe epilepsy with normal MRI.
Epilepsy Behav 2015; 46:103-8EB

Abstract

BACKGROUND

Increased MRI T2 signal is commonly present not only in the hippocampus but also in other temporal structures of patients with temporal lobe epilepsy (TLE), and it is associated with histological abnormalities related to the epileptogenic lesion.

OBJECTIVE

This study aimed to verify the distribution of T2 increased signal in temporal lobe structures and its correlations with clinical characteristics of TLE patients with (TLE-HS) or without (TLE-NL) MRI signs of hippocampal sclerosis.

METHODS

We selected 203 consecutive patients: 124 with TLE-HS and 79 with TLE-NL. Healthy controls (N=59) were used as a comparison group/comparative group. T2 multiecho images obtained via a 3-T MRI were evaluated with in-house software. T2 signal decays were computed from five original echoes in regions of interest in the hippocampus, amygdala, and white matter of the anterior temporal lobe. Values higher than 2 standard deviations from the mean of controls were considered as abnormal.

RESULTS

T2 signal increase was observed in the hippocampus in 78% of patients with TLE-HS and in 17% of patients with TLE-NL; in the amygdala in 13% of patients with TLE-HS and in 14% of patients with TLE-NL; and in the temporal lobe white matter in 22% of patients with TLE-HS and in 8% of patients with TLE-NL. Group analysis demonstrated a significant difference in the distribution of the T2 relaxation times of the hippocampus (ANOVA, p<0.0001), amygdala (p=0.003), and temporal lobe white matter (p<0.0001) ipsilateral to the epileptogenic zone for patients with TLE-HS compared with controls but only for the amygdala (p=0.029) and temporal lobe white matter (ANOVA, p=0.025) for patients with TLE-NL compared with controls. The average signal from the hippocampus ipsilateral to the epileptogenic zone was significantly higher in patients with no family history of epilepsy (two-sample T-test, p=0.005).

CONCLUSION

Increased T2 signal occurs in different temporal structures of patients with TLE-HS and in patients with TLE-NL. The hippocampal hyperintense signal is more pronounced in patients without family history of epilepsy and is influenced by earlier seizure onset. These changes in T2 signal may be associated with structural abnormalities related to the epileptogenic zone or to the nature of the initial precipitating injury in patients with TLE.

Authors+Show Affiliations

Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, SP, Brazil. Electronic address: kubota187@gmail.com.Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, SP, Brazil. Electronic address: accoan@gmail.com.Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, SP, Brazil. Electronic address: yasuda.clarissa@gmail.com.Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, SP, Brazil. Electronic address: fcendes@unicamp.br.

Pub Type(s)

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

Language

eng

PubMed ID

25936278

Citation

Kubota, Bruno Yukio, et al. "T2 Hyperintense Signal in Patients With Temporal Lobe Epilepsy With MRI Signs of Hippocampal Sclerosis and in Patients With Temporal Lobe Epilepsy With Normal MRI." Epilepsy & Behavior : E&B, vol. 46, 2015, pp. 103-8.
Kubota BY, Coan AC, Yasuda CL, et al. T2 hyperintense signal in patients with temporal lobe epilepsy with MRI signs of hippocampal sclerosis and in patients with temporal lobe epilepsy with normal MRI. Epilepsy Behav. 2015;46:103-8.
Kubota, B. Y., Coan, A. C., Yasuda, C. L., & Cendes, F. (2015). T2 hyperintense signal in patients with temporal lobe epilepsy with MRI signs of hippocampal sclerosis and in patients with temporal lobe epilepsy with normal MRI. Epilepsy & Behavior : E&B, 46, pp. 103-8. doi:10.1016/j.yebeh.2015.04.001.
Kubota BY, et al. T2 Hyperintense Signal in Patients With Temporal Lobe Epilepsy With MRI Signs of Hippocampal Sclerosis and in Patients With Temporal Lobe Epilepsy With Normal MRI. Epilepsy Behav. 2015;46:103-8. PubMed PMID: 25936278.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - T2 hyperintense signal in patients with temporal lobe epilepsy with MRI signs of hippocampal sclerosis and in patients with temporal lobe epilepsy with normal MRI. AU - Kubota,Bruno Yukio, AU - Coan,Ana Carolina, AU - Yasuda,Clarissa Lin, AU - Cendes,Fernando, Y1 - 2015/05/01/ PY - 2014/09/19/received PY - 2015/03/17/revised PY - 2015/04/01/accepted PY - 2015/5/5/entrez PY - 2015/5/6/pubmed PY - 2016/1/14/medline KW - Hippocampal sclerosis KW - MRI-negative epilepsy KW - Magnetic resonance KW - T2 relaxometry KW - Temporal lobe epilepsy SP - 103 EP - 8 JF - Epilepsy & behavior : E&B JO - Epilepsy Behav VL - 46 N2 - BACKGROUND: Increased MRI T2 signal is commonly present not only in the hippocampus but also in other temporal structures of patients with temporal lobe epilepsy (TLE), and it is associated with histological abnormalities related to the epileptogenic lesion. OBJECTIVE: This study aimed to verify the distribution of T2 increased signal in temporal lobe structures and its correlations with clinical characteristics of TLE patients with (TLE-HS) or without (TLE-NL) MRI signs of hippocampal sclerosis. METHODS: We selected 203 consecutive patients: 124 with TLE-HS and 79 with TLE-NL. Healthy controls (N=59) were used as a comparison group/comparative group. T2 multiecho images obtained via a 3-T MRI were evaluated with in-house software. T2 signal decays were computed from five original echoes in regions of interest in the hippocampus, amygdala, and white matter of the anterior temporal lobe. Values higher than 2 standard deviations from the mean of controls were considered as abnormal. RESULTS: T2 signal increase was observed in the hippocampus in 78% of patients with TLE-HS and in 17% of patients with TLE-NL; in the amygdala in 13% of patients with TLE-HS and in 14% of patients with TLE-NL; and in the temporal lobe white matter in 22% of patients with TLE-HS and in 8% of patients with TLE-NL. Group analysis demonstrated a significant difference in the distribution of the T2 relaxation times of the hippocampus (ANOVA, p<0.0001), amygdala (p=0.003), and temporal lobe white matter (p<0.0001) ipsilateral to the epileptogenic zone for patients with TLE-HS compared with controls but only for the amygdala (p=0.029) and temporal lobe white matter (ANOVA, p=0.025) for patients with TLE-NL compared with controls. The average signal from the hippocampus ipsilateral to the epileptogenic zone was significantly higher in patients with no family history of epilepsy (two-sample T-test, p=0.005). CONCLUSION: Increased T2 signal occurs in different temporal structures of patients with TLE-HS and in patients with TLE-NL. The hippocampal hyperintense signal is more pronounced in patients without family history of epilepsy and is influenced by earlier seizure onset. These changes in T2 signal may be associated with structural abnormalities related to the epileptogenic zone or to the nature of the initial precipitating injury in patients with TLE. SN - 1525-5069 UR - https://www.unboundmedicine.com/medline/citation/25936278/T2_hyperintense_signal_in_patients_with_temporal_lobe_epilepsy_with_MRI_signs_of_hippocampal_sclerosis_and_in_patients_with_temporal_lobe_epilepsy_with_normal_MRI_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1525-5050(15)00146-8 DB - PRIME DP - Unbound Medicine ER -