title: T2 mapping outperforms normalised FLAIR in identifying hippocampal sclerosis.
abstract: BACKGROUND
  Qualitatively, FLAIR MR imaging is sensitive to the detection of hippocampal sclerosis (HS). Quantitative analysis of T2 maps provides a useful objective measure and increased sensitivity over visual inspection of T2-weighted scans. We aimed to determine whether quantification of normalised FLAIR is as sensitive as T2 mapping in detection of HS.
  
  
  METHODS
  Dual echo T2 and FLAIR MR images were retrospectively analysed in 27 patients with histologically confirmed HS and increased T2 signal in ipsilateral hippocampus and 14 healthy controls. Regions of interest were manually segmented in all hippocampi aiming to avoid inclusion of CSF. Hippocampal T2 values and measures of normalised FLAIR Signal Intensity (nFSI) were compared in healthy and sclerotic hippocampi.
  
  
  RESULTS
  HS was identified on T2 values with 100% sensitivity and 100% specificity. HS was identified on nFSI measures with 60% sensitivity and 93% specificity.
  
  
  CONCLUSIONS
  T2 mapping is superior to nFSI for identification of HS.
authors.affiliation: Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK ; MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK.
authors.forename: R
authors.initials: R
authors.lastname: Rodionov
authors.affiliation: Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK ; MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK.
authors.forename: P A
authors.initials: PA
authors.lastname: Bartlett
authors.affiliation: Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK ; MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK ; Department of Radiology, Chengdu Military General Hospital, China.
authors.forename: Ci
authors.initials: C
authors.lastname: He
authors.affiliation: Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK ; MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK ; Centre for Medical Image Computing, Translational Imaging Group, University College London, London, UK.
authors.forename: S B
authors.initials: SB
authors.lastname: Vos
authors.affiliation: Department of Neurology and Epileptology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
authors.forename: N K
authors.initials: NK
authors.lastname: Focke
authors.affiliation: Centre for Medical Image Computing, Translational Imaging Group, University College London, London, UK.
authors.forename: S G
authors.initials: SG
authors.lastname: Ourselin
authors.affiliation: Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK ; MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK.
authors.forename: J S
authors.initials: JS
authors.lastname: Duncan
mesh_terms: D000293:Adolescent; D000328:Adult; D001931:Brain Mapping / Q000379:methods*; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis*; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012598:Sclerosis / Q000473:pathology; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Hippocampal sclerosis; T2 FLAIR; T2 mapping
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