[PDF] Seven-Tesla MRI of Hippocampal Sclerosis: An In Vivo Feasibility Study With Histological Correlations | Semantic Scholar (2024)

The initial results suggest that HS type 1, HS type 2 and no-HS subtypes can be distinguished from each other using ex vivo UHF MRI based on T2-weighted morphologic images and the assessment of the parameter product.

It is demonstrated that high-resolution diffusion-weighted MRI can resolve subtle microstructural changes in epileptic hippocampal tissue corresponding to histopathological features in MTLE.

Pseudo-continuous ASL offers a promising approach to detect interictal hypoperfusion in TLE and as a clinical alternative to SPECT and PET due to non-invasiveness and easy accessibility.

“Gliosis only” has different MRI hippocampal characteristics than HS: less volume loss, less increase of the T2-w signal intensity, preservation of internal architecture, and more contralateral affection.

Technical improvements of resective surgery techniques facilitate successful and safe operations in highly delicate brain areas like the perisylvian area in operculoinsular epilepsy, and have opened the option of epilepsy surgery to patients previously not considered surgical candidates.

This article aims to give guidance on clinical 7T MRI epilepsy management by giving recommendations on referral, suitable7T MRI protocols and image interpretation, and multiple non-structural MRI techniques that benefit from 7T and hold promise as future directions in epilepsy.

The most common abnormalities, such as hippocampal sclerosis, malformations of cortical development and vascular malformation, detected by neuroimaging in patients with epilepsy are reviewed to help understand the correlation between these changes and the course, treatment and prognosis of epilepsy.

The diagnostic yield was beneficial, but with 19% new 7 T over 3 T findings, not major, and epilepsy outcomes worse than ILAE Class 1 in two out of the four operated cases with new 7 T findings.

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Ultrahigh-field-strength MR imaging permitted detection of selectively greater Ammon horn atrophy in patients with TLE and hippocampal sclerosis and paucity of digitations is a deformity of the hippocampal head that was detected independent of hippocampal atrophy.

High-resolution MRI suggests that minute internal structural changes in the hippocampus reflect neuronal cell loss or gliosis, possibly in the early stage, and also show laterality of changes more sensitively.

High‐resolution imaging with confirmed histopathologic diagnosis, as well as advanced neurophysiologic and molecular genetic measures, will be a powerful tool in the future to address issues and help to predict each patient's probability to control their epilepsy in mTLE‐HS conditions.

Preliminary data is provided suggesting new ultrastructural hippocampal details seen on 3T MR imaging had histopathologic correlates and their utility in the development of a quantitative analysis assessment tool for application in surgical-candidate selection.

The findings show that MCD, which is significantly associated with HS, is the most common lesion in TLE and support the concept that an optimal outcome is obtained when mesial and neocortical structures are removed.

Although the reliability of hippocampal volumetry at 3 Tesla was similar to the literature values obtained at 1.5 Tesla, hippocampal border definition is argued to be more confident and easier because of the improved signal-to-noise characteristics.

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