Heterogeneidade do tempo de relaxamento T2 no hipocampo de pacientes com epilepsia do lobo temporal e esclerose hipocampal
Data
2024-07-02
Autores
Mendes, Victor de Cicco 
Orientadores
Santos, José Eduardo Peixoto
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
As epilepsias são um conjunto de doenças caracterizadas por crises recorrentes, tendo como principal tratamento o uso de fármacos anti-crise. Entretanto, nem todos os pacientes respondem ao tratamento. Para estes, a cirurgia ressectiva é indicada e, para seu planejamento, é necessário o uso de Ressonância Magnética. Dentre os farmacoresistentes, a esclerose hipocampal é a principal etiologia, e pode ser observada na RM pelo sinal T2. Achados recentes indicam que diferentes mudanças microestruturais afetam T2 de maneiras distintas em Alzheimer, e esta medida seria importante para identificar alterações patológicas. Diante disso, a hipótese é que na esclerose hipocampal observada na epilepsia também pode ser identificada pela medida de heterogeneidade do sinal T2. Analisar e comparar a média do tempo de relaxamento T2 com sua heterogeneidade no hipocampo de pacientes hígidos e pacientes com epilepsia e esclerose hipocampal para averiguar se a heterogeneidade apresenta perfil superior na identificação hipocampal esclerótico quando comparada à média do relaxamento. O tempo de relaxamento T2 foi medido pela média e heterogeneidade no hipocampo de 20 pacientes com epilepsia e 4 controles, utilizando o software Fiji® para análise de média e Desvio-Padrão (Heterogeneidade) dos mapas de relaxamento. A análise estatística foi feita pelo software Jamovi®. Amédia do tempo de relaxamento T2 tem uma maior sensibilidade para diferenciar o grupo controle dos pacientes com epilepsia, diferente da heterogeneidade. Ao contrário do observado em pacientes com Alzheimer, a heterogeneidade não é uma medida útil para identificar a esclerose hipocampal na epilepsia.
Epilepsies are a group of disorders characterized by recurrent seizures, with anti-seizure medications being the primary treatment. However, not all patients respond to these treatments. For those who are drug-resistant, resective surgery is recommended, and planning for this surgery requires the use of Magnetic Resonance Imaging (MRI). Among drug-resistant patients, hippocampal sclerosis is the most common cause and can be observed in MRI through the T2 signal. Recent findings indicate that different microstructural changes affect T2 in various ways in Alzheimer's disease, suggesting that this measure is important for identifying pathological alterations. Therefore, the hypothesis is that hippocampal sclerosis in epilepsy can also be identified by measuring the heterogeneity of the T2 signal. To analyze and compare the mean T2 relaxation time and its heterogeneity in the hippocampus of healthy individuals and patients with epilepsy and hippocampal sclerosis, to determine if heterogeneity offers superior identification of sclerotic hippocampal regions compared to the mean T2 relaxation time. The T2 relaxation time was measured using mean and heterogeneity values in the hippocampi of 20 patients with epilepsy and 4 controls. The Fiji® software was used to analyze the mean and standard deviation (heterogeneity) of the relaxation maps. Statistical analysis was performed using the Jamovi® software. The mean T2 relaxation time showed greater sensitivity in differentiating the control group from patients with epilepsy, unlike heterogeneity. Contrary to findings in Alzheimer's patients, heterogeneity is not a useful measure for identifying hippocampal sclerosis in epilepsy.
Epilepsies are a group of disorders characterized by recurrent seizures, with anti-seizure medications being the primary treatment. However, not all patients respond to these treatments. For those who are drug-resistant, resective surgery is recommended, and planning for this surgery requires the use of Magnetic Resonance Imaging (MRI). Among drug-resistant patients, hippocampal sclerosis is the most common cause and can be observed in MRI through the T2 signal. Recent findings indicate that different microstructural changes affect T2 in various ways in Alzheimer's disease, suggesting that this measure is important for identifying pathological alterations. Therefore, the hypothesis is that hippocampal sclerosis in epilepsy can also be identified by measuring the heterogeneity of the T2 signal. To analyze and compare the mean T2 relaxation time and its heterogeneity in the hippocampus of healthy individuals and patients with epilepsy and hippocampal sclerosis, to determine if heterogeneity offers superior identification of sclerotic hippocampal regions compared to the mean T2 relaxation time. The T2 relaxation time was measured using mean and heterogeneity values in the hippocampi of 20 patients with epilepsy and 4 controls. The Fiji® software was used to analyze the mean and standard deviation (heterogeneity) of the relaxation maps. Statistical analysis was performed using the Jamovi® software. The mean T2 relaxation time showed greater sensitivity in differentiating the control group from patients with epilepsy, unlike heterogeneity. Contrary to findings in Alzheimer's patients, heterogeneity is not a useful measure for identifying hippocampal sclerosis in epilepsy.
Descrição
Citação
MENDES, Victor de Cicco. Heterogeneidade do tempo de relaxamento T2 no hipocampo de pacientes com epilepsia do lobo temporal e esclerose hipocampal. 2024. 31 f. Trabalho de Conclusão de Curso (Técnico em Radiologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2024.