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Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2020.tde-18122019-145026
Document
Author
Full name
Beatriz de Almeida Prado
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2019
Supervisor
Committee
Santos, Antonio Carlos dos (President)
Caritá, Edilson Carlos
Simão, Gustavo Novelino
Velasco, Tonicarlo Rodrigues
Title in Portuguese
Análise quantitativa do volume e intensidade de sinal T2 dos hipocampos em pacientes com Epilepsia do Lobo Temporal operados no Hospital das Clínicas de Ribeirão Preto - HCFMRP-USP
Keywords in Portuguese
Epilepsia do lobo temporal
Hipocampo
Imagem por Ressonância Magnética
Intensidade de sinal
Volumetria
Abstract in Portuguese
OBJETIVO: Estimar quantitativamente o volume e intensidade de sinal T2 dos hipocampos de pacientes com ELT operados no HCFMRP-USP e comparar a acuidade diagnóstica em relação à análise qualitativa nos exames de Ressonância Magnética pré-operatórios. MATERIAIS E MÉTODOS: Este foi um estudo retrospectivo, em uma mesma instituição, incluindo os pacientes com diagnóstico clínico e histopatológico comprovado de esclerose hipocampal e que tiveram exame de RM realizado no período pré-operatório. Foram realizadas quantificações volumétricas dos hipocampos dos pacientes operados usando o software de imagem FreeSurfer, versão 6.0 (Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, EUA), e após, realizado o índice de assimetria (IA) entre o lado alterado e o contralateral (IA : (HA - HS/ HA+HC)*100), e comparado com o resultado de um grupo controle pareado para a idade e sexo. Em um segundo momento, foi quantificada a intensidade de sinal T2 a partir das imagens com contraste do tipo FLAIR, que foram co-registradas tridimensionalmente com imagens de T1 utilizando o método Affine com 12 graus de liberdade, e comparado com o lado contralateral. RESULTADOS: 99 pacientes, sendo 46 (46,5%) do sexo masculino e 53 (53,5%) do sexo feminino, com idade média de 41,6 anos (20 - 64) anos foram analisados. O índice de assimetria médio dos hipocampos dos pacientes com epilepsia do lobo temporal identificado foi de , com desvio padrão de , e o do grupo controle de .A intensidade de sinal T2 dos hipocampos alterados foi de , com desvio padrão de e o do lado contralateral de , com desvio padrão de. CONCLUSÃO: Houve diferença estatística nos valores de índice de assimetria dos pacientes com ELT em relação ao grupo controle saudável, bem como na análise da intensidade de sinal T2 em relação ao lado contralateral. A utilização destas ferramentas quantitativas deve auxiliar na acurácia diagnóstica da ressonância magnética em casos duvidosos na análise visual.
Title in English
Quantitative analysis of hippocampal volume and T2 signal intensity in patients with temporal mesial lobe epilepsy operated at Hospital das Clínicas de Ribeirão Preto HCFMRP-USP
Keywords in English
MRI
T2 signal intensity
Temporal mesial lobe epilepsy
Volumetry
Abstract in English
PURPOSE: Estimate quantitatively the hippocampal volume and T2 signal intensity of in patients with temporal mesial lobe epilepsy operated at HCFMRP-USP and analysis of diagnostic accuracy compared to visual evaluation. MATERIALS AND METHODS: This was a retrospective, single-intitution study, including patients with a proven clinic and histological diagnosis of hippocampal sclerosis and that underwent pre operatory brain MRI studies. Quantification of hippocampal volume was performed with FreeSurfer software, version 6.0 (Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, EUA), and then calculated the asymmetry index (AI) between the altered hippocampus (AH) and the contralateral (CH) (AI : (AH - CH/ AH + CH)*100), and compared to results from a age and sex matched control group. In an second moment, T2 signal intensity was quantified from FLAIR sequences that were tridimensionally co-registered with T1W images using the Affine method with 12 degrees liberty, and compared to the contralateral hippoccampus. RESULTS: 99 patiens, 46 women (46,5%) and 53 men (53,5%), with a mean age of 41,6 years (20 - 64) were analyzed. The hippocampal assimetry index of patients with temporal mesial lobe epilepsy was of, with a standard deviation of, and of the control group was , with a standard deviation of. The T2 signal intensity of the hippocampal with sclerosis was of, with standard deviation of , and of the contralateral side of , with a standard deviation of. CONCLUSION: There was a significant statistical difference of the Assimetry Index values between patients with TMLE and the matched control group. There was also significant statistical difference between the T2 signal intensity of the hippocampal with sclerosis and the contralateral. The use of these quantitative tools must aid the diagnostic accuracy or MRI in cases where the qualitative analysis was inconclusive.
 
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Publishing Date
2020-01-15
 
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