Hippocampal “gliosis only” on MR imaging represents a distinct entity in epilepsy patients

Purpose The purpose of this study is to evaluate whether patients with drug-resistant mesial temporal lobe epilepsy (TLE) due to hippocampal “gliosis only” have different MRI features than those with hippocampal sclerosis (HS). Most TLE patients have HS corresponding to severe neuronal loss and glio...

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Bibliographic Details
Published in:Neuroradiology 2018-02, Vol.60 (2), p.161-168
Main Authors: Hattingen, Elke, Enkirch, Simon Jonas, Jurcoane, Alina, Kruse, Maximilian, Delev, Daniel, Grote, Alexander, Becker, Albert
Format: Article
Language:English
Subjects:
Adult
Amygdala
Amygdala - diagnostic imaging
Amygdala - pathology
Amygdala - surgery
Architecture
Diagnostic Neuroradiology
Drug resistance
Epilepsy
Epilepsy, Temporal Lobe - diagnostic imaging
Epilepsy, Temporal Lobe - pathology
Epilepsy, Temporal Lobe - surgery
Female
Gliosis
Gliosis - diagnostic imaging
Gliosis - pathology
Gliosis - surgery
Hippocampus
Hippocampus - diagnostic imaging
Hippocampus - pathology
Hippocampus - surgery
Humans
Imaging
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Male
Medicine
Medicine & Public Health
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Patients
Preservation
Principal components analysis
Radiology
Retrospective Studies
Sclerosis
Temporal lobe
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Summary:Purpose The purpose of this study is to evaluate whether patients with drug-resistant mesial temporal lobe epilepsy (TLE) due to hippocampal “gliosis only” have different MRI features than those with hippocampal sclerosis (HS). Most TLE patients have HS corresponding to severe neuronal loss and gliosis, but a few have “gliosis only” without significant reduction of neuronal density. Methods We analyzed the morphology of cerebral 3 T MRIs (T1, T2, and FLAIR) of 103 patients with HS and 20 with “gliosis only” concerning hippocampal and amygdala aspect, volumes, and signal intensity (SI) using Fisher’s exact test, Student’s t test, and principal component analysis. Results Visually, the ipsilateral hippocampus was hyperintense in both groups, but SI was markedly increased in 74% of HS and in 25% of “gliosis only” patients; the ipsilateral hippocampus was smaller in 92% of HS and in 50% of “gliosis only” patients, and its internal architecture was lost in 57% of HS and 5% of “gliosis only” patients; the contralateral hippocampal SI was altered in 25% of HS and in 70% of “gliosis only” patients (all p  
ISSN:0028-3940
1432-1920
DOI:10.1007/s00234-017-1939-3