Background and Purpose To apply automated quantitative volumetric MRI analyses to patients diagnosed with Rasmussen’s encephalitis (RE), to determine the predictive value of lobar volumetric measures, and to assess regional atrophy difference and monitor disease progression using these measures. Materials and Methods Nineteen patients (42 scans) with diagnosed RE were studied. Two control groups were used: one with 42 age- and gender-matched normal subjects; the other with 42 non-RE epilepsy patients with the same disease duration as RE patients. Volumetric analysis was performed on T1-weighted images using BrainSuite. Ratios of volumes from the affected hemisphere divided by those from the unaffected hemisphere were used as input to a logistic regression classifier, which was trained to discriminate patients from controls. Using the classifier, we compared the predictive accuracy of all the volumetric measures. These ratios were further used to assess regional atrophy difference and to correlate with epilepsy duration. Results Interhemispheric and frontal lobe ratios had the best prediction accuracy to separate RE patients from normal and non-RE epilepsy controls. The insula showed significantly more atrophy compared to all the other cortical regions. Patients with longitudinal scans showed progressive volume loss of the affected hemisphere. Atrophy of the frontal lobe and insula correlated significantly with epilepsy duration. Conclusions Automated quantitative volumetric analysis provides accurate separation of RE patients from normal controls and non-RE epilepsy patients, and thus may assist diagnosis of RE. Volumetric analysis could also be included as part of followup for RE patients to assess disease progression.
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