title: MRI volumetric analysis in rasmussen encephalitis: a longitudinal study.
abstract: OBJECTIVE
  Rasmussen encephalitis is a progressive inflammatory process with difficult-to-control focal or lateralized seizure activity, leading to hemispheric dysfunction and atrophy in advanced stages. Anatomic changes of atrophy may be subtle in earlier phases of the disease, and progressive changes on serial scans may be difficult to detect. We report a case of early-stage Rasmussen encephalitis with a relatively stable clinical course in whom we performed magnetic resonance imaging (MRI)-based volumetric analysis over an interval of 1 year, to assess for volumetric changes.
  
  
  METHODS
  Volumetric analysis was performed on two successive MRI scans obtained at age 5 and 6 years, by using the CARDVIEWS program (J Cogn Neurosci, 1996). The images were segmented into gray- and white-matter structures according to signal intensity of their borders semiautomatically, with manual corrections. The cerebral cortex was further subdivided into smaller parcellation units according to anatomic landmarks identifiable on MRI.
  
  
  RESULTS
  Stable left cerebral hemispheric atrophy and progressive atrophy in the left precentral gyrus, left inferior frontal gyrus, and left cerebellar atrophy were detected over the 1-year interval.
  
  
  CONCLUSIONS
  Volumetric analysis enables early detection and quantification of anatomic changes, identification of focal involvement, and assists in determining the severity of disease and timing for surgical interventions such as hemispherectomy.
authors.affiliation: Department of Neurology, Children's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A. maxtakeoka@aol.com
authors.forename: Masanori
authors.initials: M
authors.lastname: Takeoka
authors.forename: Francine
authors.initials: F
authors.lastname: Kim
authors.forename: Verne S
authors.initials: VS
authors.lastname: Caviness
authors.forename: David N
authors.initials: DN
authors.lastname: Kennedy
authors.forename: Nikos
authors.initials: N
authors.lastname: Makris
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Holmes
mesh_terms: D001284:Atrophy; D002531:Cerebellum / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004292:Dominance, Cerebral / Q000502:physiology; D004660:Encephalitis / Q000175:diagnosis* / Q000473:pathology; D020938:Epilepsy, Partial, Motor / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008432:Mathematical Computing