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Introduction: The use of Magnetic Resonance Imaging (MRI) T2 relaxometry and spectroscopy has added new dimensions to the imaging of Temporal Lobe Epilepsy (TLE). Advanced techniques like MRI diffusion and MRI perfusion are new additions to the MRI protocol for epilepsy. Aim: To study the diagnostic value of T2 relaxation time in Electroencephalogram (EEG) confirmed seizure cases. Materials and Methods: A single-centre, cross-sectional study was conducted at Department of Radiodiagnosis, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India, from December 2020 to November 2022 at a tertiary care hospital. All patients were subjected to MRI with a special epilepsy protocol and T2 relaxometry. Hippocampal T2 relaxation values for each slice were measured by placing a Region of Interest (ROI) on the representative image obtained from the T2 relaxometry sequence, focusing on the hippocampus in both the control and study groups. The control group (n=30) consisted of healthy volunteers, whereas the case group (n=36) comprised patients presenting with a history of seizures with positive MRI and EEG findings. Mean T2 relaxation time was calculated in each ROI, and an average was derived. Mean and Standard Deviation (SD) were calculated for the continuous variables, while ratios and proportions were calculated for the categorical variables. To determine the association of T2 relaxometry values in the study and control groups, an unpaired t-test was used. Results: The mean age of participants was 25.14±9.35 years (ranging from 9 to 51 years). The male-to-female ratio was 1.25:1. Hippocampal atrophy (32 out of 36 cases) and T2 signal alteration (30 out of 36 cases) were the most commonly identified features in Mesial Temporal Sclerosis (MTS). MRI without T2 relaxometry had a sensitivity of 94%. In two cases, where only mild hippocampal atrophy was identified in the conventional MRI sequence, making the diagnosis dubious, T2 relaxometry revealed increased T2 relaxation time in the head of the hippocampus and guided a proper diagnosis. EEG was able to lateralise seizures in 8 out of 13 right MTS cases (61.5%), 10 out of 17 left MTS cases (58.9%), and 5 out of 6 cases of bilateral MTS (83%). Conclusion: T2 relaxometry allows quantification of hippocampal signal intensity, allowing the detection of even subtle changes in signal intensity that are difficult to perceive by visual assessment. [ABSTRACT FROM AUTHOR]

Background: Mesial Temporal Sclerosis, also known as MTS, is a condition that causes medial temporal lobe epilepsy (MTLE) and is characterized by the loss of hippocampal neurons. Multiple researches on individuals with hippocampal sclerosis (HS) have demonstrated that MRI (magnetic resonance imaging) is an exhaustive method for locating the EF (epileptogenic focus). Aims & Objectives: To study Partial Loss of Hippocampal Striations (PLHS) as a diagnostic parameter using 3.0 Tesla MRI to increase the confidence of diagnosing Mesial Temporal Sclerosis (MTS). Material & methods: This prospective research was performed in 55 patients who had undergone 3T (GE SIGNA HDX) brain imaging under epilepsy protocol that included T2 axial, coronal FLAIR and 3D SPGR hippocampal volume assessment in addition to high resolution T2 coronal imaging over a period of two years at Department of Radiodiagnoses and Imaging (DORAI), Bharat Scans, Chennai, India. Results: The detection of abnormal signal intensity (SI) on FLAIR (fluid attenuated inversion-recovery) images had a sensitivity (Sn.) of 55 percent, specificity (Sp.) of 97 percent, & accuracy of 56 percent [right side (RS)] and Sn. of 35 percent, Sp. of 74 percent, & accuracy of 61 percent [left side (LS)] for the treatment of MTLE. The detection of PLHS on T2-weighted images had a Sn. of 81 percent, Sp. of 87 percent, & accuracy of 64 percent (RS) and a Sn. of 71 percent, Sp. of 81 percent, & accuracy of 64 percent (LS) for the treatment of MTLE. Conclusion: PLHS is more Sn. and Sp, for the diagnosis of bilateral MTLE. [ABSTRACT FROM AUTHOR]