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Qualitative Comparison of 3-T and 1.5-T MRI in the Evaluation of Epilepsy

Pramit M. Phal1, Alexander Usmanov1, Gary M. Nesbit1, James C. Anderson1, David Spencer2, Paul Wang1, Jonathan A. Helwig1, Colin Roberts2 and Bronwyn E. Hamilton1

1 Division of Neuroradiology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd,, Mail Code CR 135, Portland, OR 97239.
2 Division of Neurology, Oregon Health & Science University, Portland, OR.


Figure 1
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  		Fig. 1A —17-year-old girl with intractable nocturnal seizures starting at age 2 years. Coronal FLAIR 1.5-T MR image shows questionable curvilinear focus of juxtacortical high signal intensity (arrows) in left occipital lobe. Abnormal signal intensity was missed at first review of images.

 

Figure 2
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  		Fig. 1B —17-year-old girl with intractable nocturnal seizures starting at age 2 years. Coronal FLAIR 3-T MR image shows curvilinear band of high signal intensity (arrows) in left occipital juxtacortical white matter without apparent mass effect. Focus was surgically resected, and histologic finding was focal cortical dysplasia with balloon cell features (Taylor's type).

 

Figure 3
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  		Fig. 2A —3-year-old boy with intractable left temporal lobe epilepsy. Coronal FLAIR 1.5-T MR image shows questionable area of subtly decreased signal intensity and size of anterior left hippocampus (arrow).

 

Figure 4
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  		Fig. 2B —3-year-old boy with intractable left temporal lobe epilepsy. Coronal FLAIR 3-T MR image shows left hippocampus smaller than in A with associated high signal intensity (arrow) and loss of internal architecture consistent with mesial temporal sclerosis. Surgical resection at age 6 years showed histologic findings confirming presence of mesial temporal sclerosis.

 

Figure 5
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  		Fig. 3A —3-year-old boy with intractable seizures. Coronal thin-slice T1-weighted spoiled gradient-recalled echo MR image suggests thickening (arrows) of right frontal cortex.

 

Figure 6
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  		Fig. 3B —3-year-old boy with intractable seizures. Companion 3-T coronal T1-weighted spoiled gradient-recalled echo MR image shows thickened indistinct cortex (arrows) in right frontal lobe. Gray–white matter contrast is better than in A.

 

Figure 7
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  		Fig. 3C —3-year-old boy with intractable seizures. Coronal 1.5-T STIR MR image suggests decreased arborization of normally T2-weighted hypointense white matter in right frontal lobe. Suggestion of thickened-appearing cortex (solid arrows) can easily be interpreted as volume averaging. Normal white-matter arborization (open arrow) is evident in left frontal lobe at site of thin cortical ribbon.

 

Figure 8
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  		Fig. 3D —3-year-old boy with intractable seizures. Companion 3-T STIR MR image shows thickening and indistinctness of right frontal gray–white matter junction (solid arrows) better than does C. Normal white-matter arborization (open arrow) is present where cortical ribbon shows normal thickness. After surgical resection of abnormal-appearing tissue at age 3 years, histologic finding was cortical glioneuronal dysplasia.

 

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