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Diagnosis of mesial temporal sclerosis with conventional versus fast spin-echo MR imaging
C R Jack1, K N Krecke, P H Luetmer
1Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN 55905.
Purpose:
To test the accuracy of fast spin-echo (FSE) imaging versus that of double-echo conventional spin-echo (CSE) imaging in identification of the increased hippocampal signal intensity associated with mesial temporal sclerosis (MTS).
Materials And Methods:
Thirty-four subjects who subsequently underwent anterior temporal lobectomy for intractable seizures and in whom the presence or absence of MTS was ascertained with certainty were imaged with CSE and FSE. Three blinded reviewers evaluated the first and second CSE images (CSE1 and CSE2) and the FSE images.
Results:
CSE1 imaging had lower accuracy than FSE (P = .038) and CSE2 (P = .006) imaging. CSE2 imaging was slightly more accurate than FSE imaging (P = .048). Contrast-to-noise ratios were lower for CSE1 imaging than for CSE2 or FSE imaging (P < .001).
Conclusion:
The FSE sequence evaluated was more time efficient than CSE imaging but slightly less accurate. Therefore, substitution of this sequence for a CSE sequence seems unwarranted.
Insights
Fast spin-echo (FSE) MRI is quicker but less accurate than conventional spin-echo (CSE) for detecting mesial temporal sclerosis (MTS). CSE2 imaging showed slightly better accuracy than FSE for identifying hippocampal signal intensity changes.
Area of Science:
- Radiology
- Neurology
- Medical Imaging
Background:
- Mesial temporal sclerosis (MTS) is a common cause of epilepsy.
- Accurate identification of hippocampal signal intensity is crucial for MTS diagnosis.
Purpose of the Study:
- To compare the accuracy of fast spin-echo (FSE) and double-echo conventional spin-echo (CSE) MRI sequences.
- To evaluate the detection of increased hippocampal signal intensity in mesial temporal sclerosis (MTS).
Main Methods:
- 34 subjects with confirmed MTS status underwent both CSE and FSE MRI.
- Three blinded reviewers assessed image accuracy.
Main Results:
- CSE1 imaging demonstrated lower accuracy than both FSE and CSE2.
- CSE2 imaging was slightly more accurate than FSE imaging (P = .048).
- Contrast-to-noise ratios were significantly lower for CSE1 compared to CSE2 and FSE.
Conclusions:
- FSE offers time efficiency over CSE but with slightly reduced accuracy.
- Current FSE sequences are not recommended as a replacement for CSE in MTS diagnosis.
- Further research may be needed to optimize FSE for improved diagnostic performance in MTS.