White-matter change in mesial temporal sclerosis: Correlation of MRI with PET, pathology, and clinical features

Purpose: To assess the magnetic resonance imaging (MRI), positron emission tomography (PET), pathology, and clinical findings of patients with the MRI feature of white-matter change (WMC) in the anterior temporal lobe. Methods: Fifty-six patients with pathologically proven mesial temporal scle rosis were included in this study. MRI and F-18-2-deoxyglucose(FDG) PET ima ges were obtained before surgery in all patients. The patients were divided into two groups according to the presence of WMC on their MRI. WMC consist s of an indistinct gray-white matter demarcation and an increased signal in tensity of the anterior temporal lobe on T-2- weighted images. The two grou ps were then compared in terms of MRI, PET, pathology, and clinical feature s. Results: The MRI feature of WMC was observed in 18(32%) of the 56 patients. PET images of those patients revealed more severe hypometabolism of the ip silateral temporal lobes (p < 0.05). In terms of histologic findings, large r numbers of heterotopic neurons were observed in the anterior temporal lob e white matter of these patients who also shared the following clinical fea tures: earlier seizure onset, frequent history of febrile convulsions, and favorable surgical outcomes. Conclusions: The MRI feature of WMC is an additive sign for correct seizure lateralization and may be related to a favorable surgical outcome in patie nts with temporal lobe epilepsy.