3-Tesla MRI and Temporal Lobe Epilepsy

Magnetic resonance imagine (MRI) is the essential tool for the diagnosis and evaluation of epileptic patients due to the possibility of it identifying the epileptogenic substrate and the decisive value for the selection of surgical candidates in cases of refractory epilepsy. Because the main role of MRI in epilepsy relates to the detection of a structural injury, the quality of the image clearly determines the results. In structural studies, it can contribute to detecting small hippocampal alterations that may be missed with conventional techniques, and it is a more reliable tool for detecting small focal cortical dysplasias (FCD), which constitute the most frequent cause of dual injury. 3-Tesla MRI also provides relevant information in functional studies. Its advantages rely on the rise in signal-to-noise ratio and its higher T2 contrast, and also, in the case of MR spectroscopy, on its higher chemical shift, which in general increases both the quality and the rapidity of acquisition. Finally, epilepsy is one of the main indications for obtaining cerebral activation maps, usually using the blood oxygen level dependent (BOLD) technique, which is one of the techniques that most benefits from the magnetic field increase.