TY - JOUR
T1 - Cerebral perfusion alterations in epileptic patients during peri-ictal and post-ictal phase
T2 - PASL vs DSC-MRI
AU - Pizzini, Francesca B.
AU - Farace, Paolo
AU - Manganotti, Paolo
AU - Zoccatelli, Giada
AU - Bongiovanni, Luigi G.
AU - Golay, Xavier
AU - Beltramello, Alberto
AU - Osculati, Antonio
AU - Bertini, Giuseppe
AU - Fabene, Paolo F.
PY - 2013/7/1
Y1 - 2013/7/1
N2 - Non-invasive pulsed arterial spin labeling (PASL) MRI is a method to study brain perfusion that does not require the administration of a contrast agent, which makes it a valuable diagnostic tool as it reduces cost and side effects. The purpose of the present study was to establish the viability of PASL as an alternative to dynamic susceptibility contrast (DSC-MRI) and other perfusion imaging methods in characterizing changes in perfusion patterns caused by seizures in epileptic patients. We evaluated 19 patients with PASL. Of these, the 9 affected by high-frequency seizures were observed during the peri-ictal period (within 5. hours since the last seizure), while the 10 patients affected by low-frequency seizures were observed in the post-ictal period. For comparison, 17/19 patients were also evaluated with DSC-MRI and CBF/CBV. PASL imaging showed focal vascular changes, which allowed the classification of patients in three categories: 8 patients characterized by increased perfusion, 4 patients with normal perfusion and 7 patients with decreased perfusion. PASL perfusion imaging findings were comparable to those obtained by DSC-MRI. Since PASL is a) sensitive to vascular alterations induced by epileptic seizures, b) comparable to DSC-MRI for detecting perfusion asymmetries, c) potentially capable of detecting time-related perfusion changes, it can be recommended for repeated evaluations, to identify the epileptic focus, and in follow-up and/or therapy-response assessment.
AB - Non-invasive pulsed arterial spin labeling (PASL) MRI is a method to study brain perfusion that does not require the administration of a contrast agent, which makes it a valuable diagnostic tool as it reduces cost and side effects. The purpose of the present study was to establish the viability of PASL as an alternative to dynamic susceptibility contrast (DSC-MRI) and other perfusion imaging methods in characterizing changes in perfusion patterns caused by seizures in epileptic patients. We evaluated 19 patients with PASL. Of these, the 9 affected by high-frequency seizures were observed during the peri-ictal period (within 5. hours since the last seizure), while the 10 patients affected by low-frequency seizures were observed in the post-ictal period. For comparison, 17/19 patients were also evaluated with DSC-MRI and CBF/CBV. PASL imaging showed focal vascular changes, which allowed the classification of patients in three categories: 8 patients characterized by increased perfusion, 4 patients with normal perfusion and 7 patients with decreased perfusion. PASL perfusion imaging findings were comparable to those obtained by DSC-MRI. Since PASL is a) sensitive to vascular alterations induced by epileptic seizures, b) comparable to DSC-MRI for detecting perfusion asymmetries, c) potentially capable of detecting time-related perfusion changes, it can be recommended for repeated evaluations, to identify the epileptic focus, and in follow-up and/or therapy-response assessment.
KW - Arterial spin labeling
KW - Epilepsy
KW - Hyperperfusion
KW - Hypoperfusion
KW - Magnetic resonance imaging
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U2 - 10.1016/j.mri.2013.03.023
DO - 10.1016/j.mri.2013.03.023
M3 - Article
C2 - 23623332
AN - SCOPUS:84878637913
VL - 31
SP - 1001
EP - 1005
JO - Magnetic Resonance Imaging
JF - Magnetic Resonance Imaging
SN - 0730-725X
IS - 6
ER -