Epilepsy protocol (MRI)

Changed by Francesco Sciacca, 20 Nov 2019

Updates to Article Attributes

Body was changed:

MRI protocol for epilepsy is a group of MRI sequences put together to improve sensitivity and specificity in identifying possible structural abnormalities that underlie seizure disorders (e.g. mesial temporal sclerosis and malformation of cortical development). MRI is the imaging procedure of choice for epilepsy investigation, especially 3 tesla MRI. 

Note: This article is intended to outline some general principles of protocol design. The specifics will vary depending on MRI hardware and software, radiologist's and referrer's preference, institutional protocols, patient factors (e.g. allergy) and time constraints. 

Sequences

Non-focal epilepsy protocol 

A good protocol for this purpose involves at least:

  • T1
    • sequence:axial and coronal; in modern scanners it can be replaced by a 3D isotropic acquisition 
  • FLAIR
    • sequence:axial and angled coronal; in modern scanners it can be replaced by a 3D isotropic acquisition 
  • inversion recovery sequences 
    • DIR
      • sequence:3D isotropic acquisition 
  • DWI/ADC
  • SWI or T2*
Temporal lobe epilepsy protocol 

A good protocol for this purpose involves at least:

  • T1
    • sequence: axial and coronal; in modern scanners it can be replaced by a 3D isotropic acquisition 
  • FLAIR
    • sequence: axial and angled coronal; in modern scanners it can be replaced by a 3D isotropic acquisition 
  • T2
    • sequence: angled coronal
  • DWI/ADC
  • SWI or T2*
  • Fiber-tracking technique

The fiber-tracking technique allow to investigate the effect of temporal lobe epilepsy on reorganization of the linguistic functions. 2,3

  • -</ul>
  • +<li><strong>Fiber-tracking technique</strong></li>
  • +</ul><p>The fiber-tracking technique allow to investigate the effect of temporal lobe epilepsy on reorganization of the linguistic functions. <sup>2,3</sup><br> </p>

References changed:

  • 2. Powell HW, Parker GJ, Alexander DC, Symms MR, Boulby PA, Wheeler-Kingshott CA, Barker GJ, Koepp MJ, Duncan JS. Abnormalities of language networks in temporal lobe epilepsy. (2007) NeuroImage. 36 (1): 209-21. <a href="https://doi.org/10.1016/j.neuroimage.2007.02.028">doi:10.1016/j.neuroimage.2007.02.028</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/17400477">Pubmed</a> <span class="ref_v4"></span>
  • 3. Ciccarelli O, Catani M, Johansen-Berg H, Clark C, Thompson A. Diffusion-based tractography in neurological disorders: concepts, applications, and future developments. (2008) The Lancet. Neurology. 7 (8): 715-27. <a href="https://doi.org/10.1016/S1474-4422(08)70163-7">doi:10.1016/S1474-4422(08)70163-7</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/18635020">Pubmed</a> <span class="ref_v4"></span>

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