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Purpose: To describe imaging findings in the hippocampus in status epilepticus with fast spin-echo (SE) magnetic resonance (MR) imaging., Materials and Methods: Five patients with status epilepticus were examined with fast SE MR imaging, and the findings were correlated with neuropathologic observations of status epilepticus., Results: One patient with diffuse bilateral hippocampal and amygdalal abnormal hyperintensity died. In three patients with hippocampal abnormal hyperintensity and enlargement, hyperintensity and enlargement, follow-up fast SE MR images depicted decreased hyperintensity and swelling; one patient has remained seizure free at 6 months follow-up; a complex partial seizure disorder developed in two, and repeat images demonstrated hippocampal atrophy., Conclusion: T2-weighted fast SE MR images demonstrate reversible abnormal hyperintensity and swelling of the hippocampus and amygdala in patients with status epilepticus. Sequential fast SE MR imaging allows differentiation of this process from neoplasia and is useful in documentation of post-status epilepticus developments such as mesial temporal sclerosis.

Purpose: This study was performed to determine the sensitivity and specificity of fast spin-echo (FSE) magnetic resonance (MR) imaging in detecting mesial temporal sclerosis., Materials and Methods: Twenty-one patients with a diagnosis of complex partial seizures were studied. Criteria for abnormality included visual detection of hippocampal MR signal abnormality and atrophy or significantly decreased hippocampal volume determined by using MR morphometric techniques., Results: The overall sensitivity and specificity of MR imaging in demonstrating correct lateralization of seizure focus were both 100%. The positive predictive value of FSE MR imaging was 100%. The negative predictive value was 50%., Conclusion: The authors recommend FSE MR imaging of the hippocampus as the imaging technique of choice in the evaluation of patients with complex partial seizures for mesial temporal sclerosis.

A case of Erdheim-Chester disease with intracerebral masses containing characteristic lipid-laden histiocytes is presented. These unusual lesions remained enhanced on magnetic resonance images obtained 8 days after injection of gadolinium diethylenetriaminepentaacetic acid (DTPA) dimeglumine. Chemical analysis of a biopsy specimen revealed a high concentration of gadolinium. Findings suggest that the Gd-DTPA complex or possibly a gadolinium-containing metabolite may be retained for extended periods in this unusual type of histiocytic lesion.