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All Journal Sriwijaya Journal of Radiology and Imaging Research
Istiqomah, Sarah Wilmar
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Dentistry Health Professions Medicine & Pharmacology Neuroscience Physics

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Optimized Brain MRI Protocol for Epilepsy Diagnosis in Semarang, Indonesia: A Prospective Study Istiqomah, Sarah Wilmar
Sriwijaya Journal of Radiology and Imaging Research Vol. 1 No. 2 (2023): Sriwijaya Journal of Radiology and Imaging Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjrir.v1i1.8

Abstract

Introduction: Epilepsy is a prevalent neurological disorder, and accurate diagnosis is crucial for effective management. Brain MRI plays a pivotal role in identifying epileptogenic foci. This study aimed to develop and evaluate an optimized brain MRI protocol for epilepsy diagnosis in Semarang, Indonesia, where access to advanced imaging may be limited. Methods: A prospective study was conducted at a tertiary care hospital in Semarang. Consecutive patients with suspected epilepsy underwent brain MRI using a standardized protocol comprising T1-weighted, T2-weighted, fluid-attenuated inversion recovery (FLAIR), and susceptibility-weighted imaging (SWI) sequences. Additional sequences like diffusion-weighted imaging (DWI) and post-contrast T1-weighted imaging were acquired when clinically indicated. Two experienced neuroradiologists independently reviewed the images, and their findings were correlated with clinical and electroencephalography (EEG) data. The diagnostic accuracy, sensitivity, specificity, and inter-rater agreement of the optimized protocol were evaluated. Results: A total of 150 patients (mean age 32.5 years, range 18-65 years) were enrolled. The optimized protocol identified epileptogenic lesions in 75 patients (50%), with the most common being mesial temporal sclerosis (30%), followed by focal cortical dysplasia (15%), and tumors (5%). The protocol demonstrated a sensitivity of 85%, a specificity of 92%, and an inter-rater agreement of 0.85 (kappa). The addition of DWI and post-contrast imaging improved the detection of subtle lesions and differentiation between tumor and inflammation. Conclusion: The optimized brain MRI protocol proved to be a valuable tool for epilepsy diagnosis in Semarang, with high diagnostic accuracy and inter-rater agreement. This protocol can be implemented in resource-constrained settings to improve the detection and characterization of epileptogenic lesions, leading to better patient management and outcomes.
Brain Magnitude Resonance Imaging Examinati on Protocol in Epilepsy Patients: A Narrative Literature Review Istiqomah, Sarah Wilmar
Sriwijaya Journal of Radiology and Imaging Research Vol. 1 No. 1 (2023): Sriwijaya Journal of Radiology and Imaging Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjrir.v1i1.211

Abstract

MRI is becoming the choice for performing high-resolution structural imaging in epilepsy. Selection of brain MRI sequences with appropriate clinical epilepsy is very important to s how abnormalities clearly so that the diagnosis can be made. The epilepsy protocol includes T1 and T2 weights, as well as fluid-attenuated inversion recovery (FLAIR). This literature review aims to describe the protocol for brain MRI examination in epilepsy patients. There is one special sequence that is used as a parameter for brain MRI examination in cases of epilepsy, namely fast spin-echo inversion recovery (FSE-IR), which is a modification of conventional inversion recovery and is used to suppress signals from certain tissues a ssociated with T2 weighting. The coronal T2 propeller sequence is the sequence for showing pathology in the hippocampus. Coronal FSE-IR is useful for evaluating the hippocampus from the coronal side by eliminating the white signal to increase the contrast between white matter and gray matter. In conclu sion, each sequence in the MRI examination protocol has a specific goal, namely to reveal pathology on the MRI slice and establish a diagnosis.
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