White-Matter Change in Mesial Temporal Sclerosis: Correlation of MRI with PET, Pathology, and Clinical Features
Dongil Choi
Departments of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorDong Gyu Na
Departments of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorCorresponding Author
Hong Sik Byun
Departments of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Address correspondence and reprint requests to Dr. H. S. Byun at Department of Radiology, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135–710, Korea. [email protected]Search for more papers by this authorYeon-Lim Suh
Diagnostic Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorSang Eun Kim
Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorDuk Woo Ro
Departments of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorII Gyu Chung
Departments of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorSeung-Chyul Hong
Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorSeung Bong Hong
Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorDongil Choi
Departments of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorDong Gyu Na
Departments of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorCorresponding Author
Hong Sik Byun
Departments of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Address correspondence and reprint requests to Dr. H. S. Byun at Department of Radiology, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135–710, Korea. [email protected]Search for more papers by this authorYeon-Lim Suh
Diagnostic Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorSang Eun Kim
Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorDuk Woo Ro
Departments of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorII Gyu Chung
Departments of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorSeung-Chyul Hong
Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorSeung Bong Hong
Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorAbstract
Summary: Purpose: To assess the magnetic resonance imaging (MRI), positron emission tomography (PET), pathology, and clinical findings of patients with the MRI feature of white-matter change (WMC) in the anterior temporal lobe.
Methods: Fifty-six patients with pathologically proven mesial temporal sclerosis were included in this study. MRI and 18F-2-deoxyglucose-(FDG) PET images were obtained before surgery in all patients. The patients were divided into two groups according to the presence of WMC on their MRI. WMC consists of an indistinct gray-white matter demarcation and an increased signal intensity of the anterior temporal lobe on T2-weighted images. The two groups were then compared in terms of MRI, PET, pathology, and clinical features.
Results: The MRI feature of WMC was observed in 18 (32%) of the 56 patients. PET images of those patients revealed more severe hypometabolism of the ipsilateral temporal lobes (p > 0.05). In terms of histologic findings, larger numbers of het-erotopic neurons were observed in the anterior temporal lobe white matter of these patients who also shared the following clinical features: earlier seizure onset, frequent history of febrile convulsions, and favorable surgical outcomes.
Conclusions: The MRI feature of WMC is an additive sign for correct seizure lateralization and may be related to a favorable surgical outcome in patients with temporal lobe epilepsy.
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