Magnetic resonance imaging–based volume studies in temporal lobe epilepsy: Pathological correlations

TLDR

The study prospectively correlated MRI hippocampal volume measurements with histopathology in 24 patients with intractable partial epilepsy undergoing anterior temporal lobectomy. Patients were prospectively imaged, excluding those with pathologically confirmed mass lesions, and hippocampal volumes were measured and compared to surgical pathology. MRI volume measurements correctly lateralized seizure origin in 71 % of patients, correlated with the severity of histopathologic changes, identified mesial temporal sclerosis in 15 cases, and increased diagnostic yield by detecting atrophy in 14 of 15 resected lobes.

Abstract

Abstract We performed a prospective study correlating magnetic resonance imaging volume measurements of the hippocampal formation with histopathology in 24 patients with intractable partial epilepsy who subsequently underwent an anterior temporal lobectomy for their seizure disorder. Patients with mass lesions verified pathologically were excluded from this study. In 71% of patients, quantitative hippocampal formation atrophy correctly lateralized the temporal lobe of seizure origin; in 29%, the volume study was indeterminant. The severity of the pathological alterations in the hippocampus correlated with the hippocampal formation volume determination. Mesial temporal sclerosis was identified in the surgically excised temporal lobe in 15 patients. The magnetic resonance imaging volume studies indicated hippocampal atrophy in the temporal lobe resected in 14 of the 15 patients. Magnetic resonance imaging‐based volume measurements of the hippocampal formation increase the diagnostic yield of magnetic resonance imaging scanning in patients with intractable partial epilepsy related to mesial temporal sclerosis.