MRI essentials in epileptology: a review from the ILAE Imaging Taskforce

Authors

Irene Wang1  Andrea Bernasconi2  Boris Bernhardt3Hal Blumenfeld4  Fernando Cendes5.  Yotin Chinvarun6  Graeme Jackson7  Victoria Morgan8  Stefan Rampp9. Anna Elisabetta Vaudano10. Paolo Federico11*1

Epilepsy Center, Cleveland Clinic, Cleveland, USA2 

Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre and Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada3 

Multimodal Imaging and Connectome Analysis lab, McConnell Brain Imaging Centre and Montreal Neurological Institute, McGill University, Montreal, Canada4 

Departments of Neurology, Neuroscience, and Neurosurgery, Yale University, New Haven, USA5 

Department of Neurology, University of Campinas – UNICAMP, Campinas, SP, Brazil6 

Phramongkutklao hospital, Bangkok, Thailand7 

The Florey Institute of Neuroscience and Mental Health and The University of Melbourne, Australia8 

Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, USA9 

Department of Neurosurgery, University Hospital Erlangen, Germany10 

Neurology Unit, University of Modena and Reggio Emilia, Modena, Italy11 

Hotchkiss Brain Institute, University of Calgary, Canada* 

Correspondence: Paolo Federico Room C1214a, Foothills Medical Centre, 1403 29th Street NW, Calgary, AB, Canada T2N 2T9

Magnetic resonance imaging (MRI) plays a central role in the management and evaluation of patients with epilepsy. It is important that structural MRI scans are optimally acquired and carefully reviewed by trained experts within the context of all available clinical data. The aim of this review is to discuss the essentials of MRI that will be useful to health care providers specialized in epilepsy, as outlined by the competencies and learning objectives of the recently developed ILAE curriculum. This review contains information on basic MRI principles, sequences, field strengths and safety, when to perform and repeat an MRI, epilepsy MRI protocol (HARNESS-MRI) and the basic reading guidelines, and common epileptic pathologies. More advanced topics such as MRI-negative epilepsy, functional MRI and diffusion-weighted imaging are also briefly discussed. Although the available resources can differ markedly across different centers, it is the hope that this review can provide general guidance in the everyday practice of using MRI for patients with epilepsy.

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