MR imaging in epilepsy with use of 3D MP-RAGE

The patients were 40 males and 33 females; their ages ranged from 1 month to 39 years (mean: 15.7 years). The patients underwent MR imaging, including spin-echo T1-weighted, turbo spin-echo proton density/T2-weighted, and 3D magnetization-prepared rapid gradient-echo (3D MP-RAGE) images. These examinations disclosed 39 focal abnormalities. On visual evaluation, the boundary of abnormal gray matter in the neuronal migration disorder (NMD) cases was most clealy shown on 3D MP-RAGE images as compared to the other images. This is considered to be due to the higher spatial resolution and the better contrast of the 3D MP-RAGE images than those of the other techniques. The relative contrast difference between abnormal gray matter and the adjacent white matter was also assessed. The results revealed that the contrast differences on the 3D MP-RAGE images were larger than those on the other images; this was statistically significant. Although the sensitivity of 3D MP-RAGE for NMD was not specifically evaluated in this study, the possibility of this disorder, in cases suspected on other images, could be ruled out. Thus, it appears that the specificity with respect to NMD was at least increased with us of 3D MP-RAGE. 3D MP-RAGE also enabled us to build three-dimensional surface models that were helpful in understanding the three-dimensional anatomy. Furthermore. 3D MP-RAGE was considered to be the best technique for evaluating hippocampus atrophy in patients with MTS. On the other hand, the sensitivity in the signal change of the hippocampus was higher on T2-weighted images. In addition, demonstration of cortical tubers of tuberous sclerosis in neurocutaneous syndrome was superior on T2-weighted images than on 3D MP-RAGE images. (K.H.)