Resumen

Background: Magnetic resonance imaging is an essential tool in the pre-surgical evaluation of patients with drug-resistant epilepsy. Objective: Our aim was to assess the value of re-imaging patients with focal drug-resistant epilepsy. Methods: Thirty patients with negative or non-conclusive 1.5 Tesla magnetic resonance imaging were rescanned with 1.5T and 3T. All of them had previous 1.5 scans with no seizure protocol in a non-specialized center. Two neuroradiologists who were blinded to prior imaging results randomly reviewed the magnetic resonance images. Kappa score was used to assess the reliability. Results: Mean age of patients was 30 (SD ± 11) years. The intra-observer agreement for the first radiologist was 0.74 for 1.5T and 0.71 for 3T. In the second radiologist it was 0.82 and 0.66, respectively. Three lesions (10%) were identified by general radiologists in non-specialized centers using a 1.5T standard protocol. In our center a consensus between two neuroradiologists using epilepsy protocol identified seven lesions (23%) using 1.5T and 10 (33%) using 3T (p < 0.01). In 28% of patients this additional information resulted in a change in clinical management. Conclusions: 3T magnetic resonance imaging rescanning improves the diagnostic yield in patients with focal epilepsy and previous negative 1.5T magnetic resonance imaging. Use of 3T magnetic resonance imaging, epilepsy protocols, and interpretation by experienced neuroradiologists is highly recommended.

Palabras clave: Epilepsy surgery lesional epilepsy magnetic resonance imaging partial epilepsy refractory epilepsy 3 tesla.

2016-07-20   |   585 visitas   |   Evalua este artículo 0 valoraciones

Vol. 68 Núm.3. Mayo-Junio 2016 Pags. 112-118 Rev Invest Clin 2016; 68(3)