Epilepsy protocol (MRI)
Disclosures
- updated 4 Sep 2022:
Nothing to disclose
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 modality 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 4,5:
-
T1
- sequence:axial and coronal; in modern scanners it can be replaced by a 3D isotropic acquisition
- purpose:
- visualising brain anatomy and morphology
- measuring cortical thickness and appreciate grey-white matter differentiation
- visualise unusual location of grey matter as in grey matter heterotopia
-
FLAIR
- sequence:axial and angled coronal; in modern scanners it can be replaced by a 3D isotropic acquisition.
- purpose: look for cortical or subcortical hyperintensities
-
SWI or T2*
- purpose: identifying haemoglobin breakdown products as in post traumatic bleed and cavernomas
- DWI/ADC
-
Double Inversion recovery Sequence (DIR)
- sequence:3D isotropic acquisition
-
T1-weighted C+
- purpose: accessing tumour-like lesions, vascular malformations, or infectious disease process
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*
-
fibre-tracking technique
- the fibre-tracking technique allow to investigate the effect of temporal lobe epilepsy on reorganisation of the linguistic functions 2,3
-<p><strong>MRI protocol for epilepsy </strong>is a group of <a href="/articles/mri-sequences-overview">MRI sequences</a> put together to improve sensitivity and specificity in identifying possible structural abnormalities that underlie seizure disorders (e.g. <a href="/articles/mesial-temporal-sclerosis">mesial temporal sclerosis</a> and <a href="/articles/mild-malformation-of-cortical-development">malformation of cortical development</a>). MRI is the imaging modality of choice for epilepsy investigation, especially 3 tesla MRI. </p><p><em>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. </em></p><h4>Sequences</h4><h5>Non-focal epilepsy protocol </h5><p>A good protocol for this purpose involves at least <sup>4,5</sup>:</p><ul>-<li>-<strong>T1</strong><ul>-<li>sequence:<strong> </strong>axial and coronal; in modern scanners it can be replaced by a 3D isotropic acquisition</li>-<li>purpose:<ul>-<li>visualising brain anatomy and morphology</li>-<li>measuring cortical thickness and appreciate grey-white matter differentiation</li>-<li>visualise unusual location of grey matter as in <a href="/articles/grey-matter-heterotopia">grey matter heterotopia</a> </li>-</ul>-</li>-</ul>-</li>-<li>-<strong>FLAIR </strong><ul>-<li>sequence:<strong> </strong>axial and angled coronal; in modern scanners it can be replaced by a 3D isotropic acquisition.</li>-<li>purpose: look for cortical or subcortical hyperintensities </li>-</ul>-</li>-<li>-<strong>SWI or T2*</strong><ul><li>purpose: identifying haemoglobin breakdown products as in post traumatic bleed and <a href="/articles/cerebral-cavernous-venous-malformation">cavernomas</a>-</li></ul>-</li>-<li><strong>DWI/ADC</strong></li>-<li>-<strong>Double Inversion recovery Sequence</strong> (<strong>DIR)</strong><ul><li>sequence:<strong> </strong>3D isotropic acquisition </li></ul>-</li>-<li>-<strong>T1-weighted C+</strong><ul><li>-<strong></strong>purpose: accessing tumour-like lesions, vascular malformations, or infectious disease process</li></ul>-</li>-</ul><h5>Temporal lobe epilepsy protocol </h5><p>A good protocol for this purpose involves at least:</p><ul>-<li>-<strong>T1</strong><ul><li>sequence: axial and coronal; in modern scanners it can be replaced by a 3D isotropic acquisition </li></ul>-</li>-<li>-<strong>FLAIR</strong><ul><li>sequence: axial and angled coronal; in modern scanners it can be replaced by a 3D isotropic acquisition </li></ul>-</li>-<li>-<strong>T2</strong><ul><li>sequence: angled coronal</li></ul>-</li>-<li><strong>DWI/ADC</strong></li>-<li>-<strong>SWI </strong>or <strong>T2*</strong>-</li>-<li>-<strong>fibre-tracking technique</strong><ul><li>the fibre-tracking technique allow to investigate the effect of temporal lobe epilepsy on reorganisation of the linguistic functions <sup>2,3</sup>-</li></ul>-</li>- +<p><strong>MRI protocol for epilepsy </strong>is a group of <a href="/articles/mri-sequences-overview">MRI sequences</a> put together to improve sensitivity and specificity in identifying possible structural abnormalities that underlie seizure disorders (e.g. <a href="/articles/mesial-temporal-sclerosis">mesial temporal sclerosis</a> and <a href="/articles/mild-malformation-of-cortical-development">malformation of cortical development</a>). MRI is the imaging modality of choice for epilepsy investigation, especially 3 tesla MRI. </p><p><em>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. </em></p><h4>Sequences</h4><h5>Non-focal epilepsy protocol </h5><p>A good protocol for this purpose involves at least <sup>4,5</sup>:</p><ul>
- +<li>
- +<strong>T1</strong><ul>
- +<li>sequence:<strong> </strong>axial and coronal; in modern scanners it can be replaced by a 3D isotropic acquisition</li>
- +<li>purpose:<ul>
- +<li>visualising brain anatomy and morphology</li>
- +<li>measuring cortical thickness and appreciate grey-white matter differentiation</li>
- +<li>visualise unusual location of grey matter as in <a href="/articles/grey-matter-heterotopia">grey matter heterotopia</a> </li>
- +</ul>
- +</li>
- +</ul>
- +</li>
- +<li>
- +<strong>FLAIR </strong><ul>
- +<li>sequence:<strong> </strong>axial and angled coronal; in modern scanners it can be replaced by a 3D isotropic acquisition.</li>
- +<li>purpose: look for cortical or subcortical hyperintensities </li>
- +</ul>
- +</li>
- +<li>
- +<strong>SWI or T2*</strong><ul><li>purpose: identifying haemoglobin breakdown products as in post traumatic bleed and <a href="/articles/cerebral-cavernous-venous-malformation">cavernomas</a>
- +</li></ul>
- +</li>
- +<li><strong>DWI/ADC</strong></li>
- +<li>
- +<strong>Double Inversion recovery Sequence</strong> (<strong>DIR)</strong><ul><li>sequence:<strong> </strong>3D isotropic acquisition </li></ul>
- +</li>
- +<li>
- +<strong>T1-weighted C+</strong><ul><li>
- +<strong></strong>purpose: accessing tumour-like lesions, vascular malformations, or infectious disease process</li></ul>
- +</li>
- +</ul><h5>Temporal lobe epilepsy protocol </h5><p>A good protocol for this purpose involves at least:</p><ul>
- +<li>
- +<strong>T1</strong><ul><li>sequence: axial and coronal; in modern scanners it can be replaced by a 3D isotropic acquisition </li></ul>
- +</li>
- +<li>
- +<strong>FLAIR</strong><ul><li>sequence: axial and angled coronal; in modern scanners it can be replaced by a 3D isotropic acquisition </li></ul>
- +</li>
- +<li>
- +<strong>T2</strong><ul><li>sequence: angled coronal</li></ul>
- +</li>
- +<li><strong>DWI/ADC</strong></li>
- +<li>
- +<strong>SWI </strong>or <strong>T2*</strong>
- +</li>
- +<li>
- +<strong>fibre-tracking technique</strong><ul><li>the fibre-tracking technique allow to investigate the effect of temporal lobe epilepsy on reorganisation of the linguistic functions <sup>2,3</sup>
- +</li></ul>
- +</li>
Unable to process the form. Check for errors and try again.