T2 tse coronal oblique 2mm ( epilepsy protocol) Plan the coronal high resolution slices on the sagittal plane; angle the position block plane perpendicular to the long axis of the hippocampus. Send only 3D to three nodes: NQ_HIPPO_VOL Node, NQ_MULTISTRUCTURE Node, NQ_TRIAGE_BRAIN Node, Whole brain, perpendicular to temporal lobe. Brain imaging with MRI identifies structural cerebral pathology that may give rise to seizures. The laterality of the hippocampal abnormality detected by both absolute values and the asymmetry index in volumetry and T2 relaxometry analysis was concordant in all cases. MR imaging volumetry detected significant left reduced hippocampal volume. The pediatric radiologists will usually protocol specific sequences they need in RIS. In this group, 176 (87%) patients had drug-resistant seizures, while 27 (13%) had been free of seizures for at least 2 years. 1 His seizures started at 11 years of age and were characterized by an aura described as fear and an epigastric sensation followed by loss of consciousness and manual automatisms. Example of regions of interest manually defined in the head (A), body (B), and tail (C) of the hippocampus of a patient with MTLE. CLINCIAL Andrea Bernasconi, MD. For the remaining 78 (38%) patients, MRI had normal findings by visual analyses. A Study on Hippocampal Atrophy in Mesial Temporal Lobe Epilepsy, Default Mode Network patterns and its interactions with memory performance in patients with Temporal Lobe Epilepsy and controls, The Effect of Electroencephalography Leads on Image Quality in Cerebral Perfusion SPECT and 18F-FDG PET/CT, Mesial Temporal Sclerosis: Accuracy of NeuroQuant versus Neuroradiologist, The spectrum of hippocampal sclerosis: a quantitative magnetic resonance imaging study, MRI of amygdala and hippocampus in temporal lobe epilepsy, Quantitative hippocampal MRI and intractable temporal lobe epilepsy, The neurobiology of temporal lobe epilepsy: too much information, not enough knowledge, Hippocampal sclerosis can be reliably detected by magnetic resonance imaging, Hippocampal sclerosis in temporal lobe epilepsy demonstrated by magnetic resonance imaging, MRI volumetric measurements of amygdala and hippocampus in temporal lobe epilepsy, Detection of hippocampal pathology in intractable partial epilepsy. 3T MRI signs of HS detected by visual or quantification analysisa. On the left side is the boxplot graphic of z scores of the volumetry asymmetry index (gray) and T2 relaxometry asymmetry index (black) of controls. B, A 28-year-old male patient with MTLE and left seizure focus. The clinical use of 7-Tesla MRI enhances Mayo Clinic's ability to manage epilepsy, certain brain and peripheral nerve tumors, and other neurological disorders. Figure 4 demonstrates the z score distribution of hippocampal volumes and T2 signal in controls (right and left hippocampus) and patients (hippocampi ipsi- and contralateral to the epileptic focus). In the sample of our patients undergoing surgery, the specificity of hippocampal volumetry and T2 signal quantification was 100% (all patients with abnormal hippocampal volume or T2 signal had confirmed histopathology of HS, and the only patient with a normal hippocampus by these quantification techniques had normal histopathology). While best practices do exist, protocol design varies according to factors that include: The needs of the patient and the specifics of the symptoms and case; The MRI equipment being used All patients underwent an MR imaging epilepsy protocol with a 3T Intera Achieva scanner (Philips Healthcare, Best, the Netherlands), which included the following: Coronal images perpendicular to the long axis of the hippocampus, defined at the sagittal image: 1) T2WI multiecho (3-mm-thick, no gap, voxel size = 0.89 × 1 × 3 mm, TR = 3300 ms, TE = 30/60/90/120/150 ms, matrix = 200 × 180, FOV = 180 × 180, TSE factor = 5; EPI factor = 5, flip angle = 90°); 2) T1WI inversion recovery (3-mm-thick, no gap, voxel size = 0.75 × 0.75 × 3 mm, TR = 3550 ms, TE = 15 ms, TI = 400 ms, matrix = 240 × 229, FOV = 180 × 180, TSE factor = 7), 3) FLAIR (fat-suppressed = spectral-attenuated inversion recovery, fat-suppressed power = 1, four-mm-thick, section gap = 1 mm, voxel size = 0.89 × 1.1 × 2.4 mm, TR = 12,000 ms, TE = 140 ms, TI = 2850 ms, matrix = 180 × 440, FOV = 200 × 200). 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