Utility of double inversion recovery MRI in paediatric epilepsy

Soares, Bruno P.; Porter, Samuel G; Saindane, Amit M.; Dehkharghani, Seena; Desai, Nilesh

doi:10.1259/bjr.20150325

Cited by 15 publications

(8 citation statements)

References 21 publications

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“…The cortical tubers also show MR imaging findings, known as the radially oriented white matter band, that are similar to the TMS of FCD type IIb. [27][28][29] Magnetization transfer contrast is a technique for improving image contrast in MR imaging, based on the difference in magnetic field-induced frequencies between mobile free water protons and macromolecular bound protons. 26,30 Pinto Gama et al 25 noted that the density of cells and calcium deposition may also play a role by causing shortening of the water T1, leading to a decrease in the effectiveness of signal suppression by magnetization transfer contrast.…”

Section: Discussionmentioning

confidence: 99%

Radiologic and Pathologic Features of the Transmantle Sign in Focal Cortical Dysplasia: The T1 Signal Is Useful for Differentiating Subtypes

Kimura

Shioya

Saito³

et al. 2019

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: The transmantle sign is a characteristic MR imaging finding often seen in focal cortical dysplasia type IIb. The transmantle sign is typically hyperintense on T2WI and FLAIR and hypointense on T1WI. However, in some cases, it shows T1 high signal. We evaluated the imaging and pathologic findings to identify the causes of the T1 high signal in the transmantle sign. MATERIALS AND METHODS: We retrospectively reviewed the preoperative imaging data of 141 consecutive patients with histologically proved focal cortical dysplasia. We selected 25 patients with focal cortical dysplasia with the transmantle sign and divided them into groups based on the pathologic focal cortical dysplasia subtype and T1 signal of the transmantle sign. We evaluated the clinical, radiologic, and pathologic findings, including the number of balloon cells and dysmorphic neurons and the severity of gliosis or calcifications and compared them among the groups. RESULTS: Nine of the 25 patients had a T1-high-signal transmantle sign; the other 16 patients did not. All 9 patients with a T1-high-signal transmantle sign were diagnosed as type IIb (group A). Of the 16 patients with no T1-high-signal transmantle sign, 13 were diagnosed as having type IIb (group B), and the other 3 patients, as type IIa (group C). The number of balloon cells was significantly higher in group A than in the other groups, but there were no differences regarding dysmorphic neurons, the severity of gliosis, or calcifications. CONCLUSIONS: Approximately 6% (9/141) of this patient series had a T1-high-signal transmantle sign, and all were type IIb. The signal may reflect a rich density of balloon cells. This finding could support the differentiation of subtypes, especially type IIb.

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Section: Discussionmentioning

confidence: 99%

Radiologic and Pathologic Features of the Transmantle Sign in Focal Cortical Dysplasia: The T1 Signal Is Useful for Differentiating Subtypes

Kimura

Shioya

Saito³

et al. 2019

AJNR Am J Neuroradiol

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“…DIR improves the visibility of gray matter particularly cortical MS lesions in comparison to standard MRI techniques [3]. In addition to its important role of DIR in MS, it also used in the detection of focal cortical dysplasia (FCD) in children and young adults with epilepsy [6].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of double inversion recovery in delineation of multiple sclerosis lesions and its clinical correlation with expanded disability scoring system

Hamed

Fathi

Mahmoud

et al. 2019

Egypt J Radiol Nucl Med

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Background: The aim of our work was to assess the diagnostic accuracy of a double inversion recovery (DIR) sequence in the detection of brain and spinal cord MS lesions. In addition, we aimed to evaluate the reliability of the correlation between GM affection and high Expanded Disability Status Scale (EDSS) to enhance the role of DIR as a practical test for clinical disability. Ninety MS patients were prospectively included in this study. Imaging was performed using Philips Intera 1.5 Tesla device. T2W-TSE, FLAIR, and DIR sequences were performed and compared to each other. Each patient was clinically assessed at the time of the MRI examination with EDSS. Results: DIR showed significantly higher total lesion load in comparison to T2 and FLAIR with increased sensitivity for cortical lesion detection by DIR. There was a positive association between patients with cortical lesions and male gender, clinical disability, cognitive changes, and higher EDSS score. Conclusion: The increased rate of cortical lesion detection by DIR does not affect its accuracy in white matter lesions count. Moreover, DIR provided a better morphological characterization and delineation of white matter lesion with good differentiation between juxtacortical and mixed white matter-gray matter lesions; thus, we recommend adding DIR sequence in routine MR protocols for MS patients.

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“…In recent years, several new sequences, such as three-dimensional fluid-attenuated inversion recovery (3D FLAIR) ( Saini et al, 2010 ; Tschampa et al, 2015 ) and 3D double inversion recovery (3D-DIR) ( Soares et al, 2016 ; Wong-Kisiel et al, 2016 ), have been used to improve the contrast of the cortex. However, the application of these sequences is limited due to several reasons.…”

Section: Introductionmentioning

confidence: 99%

Gray-matter-specific MR imaging improves the detection of epileptogenic zones in focal cortical dysplasia: A new sequence called fluid and white matter suppression (FLAWS)

Chen

Qian

Kober

et al. 2018

NeuroImage: Clinical

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ObjectivesTo evaluate the diagnostic value and characteristic features of FCD epileptogenic zones using a novel sequence called fluid and white matter suppression (FLAWS).Materials and methodsThirty-nine patients with pathologically confirmed FCD and good surgery outcomes (class I or II, according to the Engel Epilepsy Surgery Outcome Scale) were retrospectively included in the study. All the patients underwent a preoperative whole-brain MRI examination that included conventional sequences (T2WI, T1WI, two-dimensional (2D) axial, coronal fluid-attenuated inversion recovery [FLAIR]) and FLAWS. An additional 3D-FLAIR MRI sequence was performed in 17 patients. To evaluate the sensitivity and specificity of FLAWS and investigate the cause of false-positives, 36 healthy volunteers were recruited as normal controls. Two radiologists evaluated all the image data. The detection rates of the FCD epileptogenic zone on different sequences were compared based on five criteria: abnormal cortical morphology (thickening, thinning, or abnormally deep sulcus); abnormal cortical signal intensity; blurred gray-white matter junction; abnormal signal intensity of the subcortical white matter, and the transmantle sign. The sensitivity and specificity of FLAWS for detecting the FCD lesions were calculated with the reviewers blinded to all the clinical information, i.e. to the patient identity and the location of the resected regions. To explore how many features were sufficient for the diagnosis of the epileptogenic zones, the frequency of each criterion in the resected regions and their combinations were assessed on FLAWS, according to the results of the assessment when the reviewers were aware of the location of the resected regions. Based on the findings of the 17 patients with an additional 3D-FLAIR scan when the reviewers were aware of the location of the resected regions, quantitative analysis of the regions of interest was used to compare the tissue contrast among 2D-axial FLAIR, 3D-FLAIR, and the FLAWS sequence. Visualization score analysis was used to evaluate the visualization of the five features on conventional, 3D-FLAIR, and FLAWS images. Finally, to explore the reason for false-positive results, a further evaluation of the whole brain FLAWS images was conducted for all the subjects.ResultsThe sensitivity and specificity for detecting the FCD lesions on the FLAWS sequence were 71.9% and 71.1%, respectively. When the reviewers were blinded to the location of the resected regions, the detection rate of the FLAWS sequence was significantly higher than that of the conventional sequences (P = 0.00). In the 17 patients who underwent an additional 3D FLAIR scan, no statistically significant difference was found between the FLAWS and the 3D-FLAIR (P = 0.25). All the patients had at least two imaging features, one of which was “the blurred junction of the gray-white matter.” The transmantle sign, which is widely believed to be a specific feature of FCD type II, could also be observed in type I on the FLAWS sequence. The relative ti...

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Utility of double inversion recovery MRI in paediatric epilepsy

Cited by 15 publications

References 21 publications

Radiologic and Pathologic Features of the Transmantle Sign in Focal Cortical Dysplasia: The T1 Signal Is Useful for Differentiating Subtypes

Radiologic and Pathologic Features of the Transmantle Sign in Focal Cortical Dysplasia: The T1 Signal Is Useful for Differentiating Subtypes

Diagnostic accuracy of double inversion recovery in delineation of multiple sclerosis lesions and its clinical correlation with expanded disability scoring system

Gray-matter-specific MR imaging improves the detection of epileptogenic zones in focal cortical dysplasia: A new sequence called fluid and white matter suppression (FLAWS)

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