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Qualitative comparison of 3-T and 1 5-T MRI in the evaluation of epilepsy Phal PM; Usmanov A; Nesbit GM; Anderson JC; Spencer D; Wang P; Helwig JA; Roberts C; Hamilton BEAJR Am J Roentgenol 2008[Sep]; 191 (3): 890-5OBJECTIVE: MRI at 3 T, which has a higher signal-to-noise ratio than 1.5-T MRI, is potentially more sensitive and specific at delineating epileptogenic lesions and may influence management of refractory epilepsy. The purposes of the current study were to compare image quality of 3-T MRI with that of 1.5-T MRI in the evaluation of epilepsy and, in cases of focal epilepsy, to compare the two field strengths in terms of lesion detection and characterization. MATERIALS AND METHODS: Retrospective review was performed on 50 sets of MR images of 25 patients who underwent both 3-T and 1.5-T brain imaging with a dedicated epilepsy protocol, including fast spin-echo T2-weighted, coronal FLAIR, coronal fast multiplanar inversion recovery, and 3D spoiled gradient-recalled echo pulse sequences. Parameters assessed were distortion and artifact, lesion conspicuity, gray-white matter differentiation, and motion. Each pulse sequence was graded on a 4-point scale. Reviewers performed qualitative assessments of the site of abnormality and the most likely diagnosis. RESULTS: MRI at 3 T outperformed MRI at 1.5 T in all four parameters and was statistically superior (p < 0.05) to 1.5-T MRI in all categories except motion. On 3-T MRI, lesions were detected in 65 of 74 cases compared with 55 of 74 cases at 1.5 T (p = 0.0364), and lesions were accurately characterized in 63 of 74 cases compared with 51 of 74 cases at 1.5 T (p = 0.0194). The odds ratios showed identification of a focal epileptogenic lesion with 3-T MRI 2.57 times as likely as identification with 1.5-T MRI and accurate characterization of lesions 2.66 times as likely as characterization with 1.5-T MRI. CONCLUSION: In evaluation of epilepsy, MRI at 3 T performed better than 1.5-T MRI in image quality, detection of structural lesions, and characterization of lesions. High-field-strength imaging should be considered for patients with intractable epilepsy and normal or equivocal findings on 1.5-T MRI.|Adolescent[MESH]|Adult[MESH]|Aged[MESH]|Brain/*pathology[MESH]|Child[MESH]|Child, Preschool[MESH]|Epilepsy/*diagnosis[MESH]|Female[MESH]|Humans[MESH]|Image Enhancement/*methods[MESH]|Infant[MESH]|Magnetic Resonance Imaging/*methods[MESH]|Male[MESH]|Middle Aged[MESH]|Radiation Dosage[MESH]|Reproducibility of Results[MESH]|Sensitivity and Specificity[MESH] |
