title: 3.0 T MRI of 2000 consecutive patients with localisation-related epilepsy.
abstract: OBJECTIVE
  Clinical guidelines suggest that all patients diagnosed with localised seizures should be investigated with MRI to identify any epileptogenic structural lesions, as these patients may benefit from surgical resection. There is growing impetus to use higher field strength scanners to image such patients, as some evidence suggests that they improve detection rates. We set out to review the detection rate of radiological abnormalities found by imaging patients with localised seizures using a high-resolution 3.0 T epilepsy protocol.
  
  
  METHODS
  Data were reviewed from 2000 consecutive adult patients with localisation-related epilepsy referred between January 2005 and February 2011, and imaged at 3.0 T using a standard epilepsy protocol.
  
  
  RESULTS
  An abnormality likely to be related to seizure activity was identified in 403/2000 (20.2%) patients, with mesial temporal sclerosis diagnosed in 211 patients. 313/2000 (15.6%) had lesions potentially amenable to surgery. Abnormalities thought unrelated to seizure activity were found in 324/2000 (16.1%), with 8.9% having evidence of ischaemic disease.
  
  
  CONCLUSIONS
  Since the introduction of the then National Institute for Clinical Excellence guidelines in 2004, the detection rate of significant pathology using a dedicated 3.0 T epilepsy protocol has not fallen, despite the increased numbers of patients being imaged. This is the largest study of epilepsy imaging at 3.0 T to date and highlights the detection rates of significant pathology in a clinical setting using a high-strength magnet. The prevalence of ischaemic disease in this population is significantly higher than first thought, and may not be incidental, as is often reported.
authors.affiliation: Department of Radiology, Royal Hallamshire Hospital, Sheffield, UK. i_craven@hotmail.com
authors.forename: I J
authors.initials: IJ
authors.lastname: Craven
authors.forename: P D
authors.initials: PD
authors.lastname: Griffiths
authors.forename: D
authors.initials: D
authors.lastname: Bhattacharyya
authors.forename: R A
authors.initials: RA
authors.lastname: Grunewald
authors.forename: T
authors.initials: T
authors.lastname: Hodgson
authors.forename: D J A
authors.initials: DJ
authors.lastname: Connolly
authors.forename: S C
authors.initials: SC
authors.lastname: Coley
authors.forename: R
authors.initials: R
authors.lastname: Batty
authors.forename: C A J
authors.initials: CA
authors.lastname: Romanowski
authors.forename: N
authors.initials: N
authors.lastname: Hoggard
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D004828:Epilepsies, Partial / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D006113:United Kingdom / Q000453:epidemiology