Utility of computed tomography and selected MR sequences in the diagnostics of patients with partial epileptic attacks
Wojciech Dzienis, Eugeniusz Tarasów, Jan Kochanowicz, Agata Szulc, Jerzy Walecki, Bożena Kubas
Med Sci Monit 2007; 13(1): 49-54
Background: Epilepsy is a disease which manifests itself with recurrent dysfunction of the brain. Epilepsy thus becomes a serious social problem and it is therefore necessary to introduce more and more up-to-date methods of its diagnostics.
Material and Methods: Examinations were performed on 85 patients with partial epileptic attacks. The study group included 43 women and 42 men who had suffered from epilepsy for 2 to 40 years. CT and MR examinations were performed in the interparoxysmal period. In MRI, T1-weighted images before and after contrast administration, T2- and PD-weighted images, and FLAIR images were analyzed.
Results: Agreement between the location of lesions in CT and EEG was evaluated with the kappa test and amounted to 0.29. Low compatibility was also found between MR and EEG and amounted to 0.33. However, compatibility between the location in CT and MR reached the level of 0.62. The most common abnormalities were asymmetry of the lateral ventricles (most often temporal horns), cortical scars, mesial temporal sclerosis (MTS), and CNS tumors. T1- and T2-weighted images enabled recognition of most of the focuses, but they failed to visualize some of the degenerative lesions in the hippocampus which were recognizable in coronal FLAIR. No statistically significant correlation was found between the patient age, duration of the disease, and type of lesion and its location.
Conclusions: The performed examinations showed that MR is the method of choice in patients with temporal epilepsy. The study protocol should include the FLAIR sequence in the coronal plane, which has high sensitivity in recognizing lesions within the hippocampus.
Keywords: Disease Progression, Adult, Female, Graves Ophthalmopathy - physiopathology, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Oculomotor Muscles - physiopathology, Retrospective Studies, Statistics as Topic