Usefulness of pulsed arterial spin labeling MR imaging in mesial temporal lobe epilepsy

Young Min Lim, Yong Won Cho, Sadat Shamim, Jeffrey Solomon, Rasmus Birn, Wen Ming Luh, William D. Gaillard, Eva K. Ritzl, William H. Theodore

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Arterial spin labeling (ASL) is a developing magnetic resonance imaging (MRI) method for noninvasive measurement of cerebral blood flow (CBF). The purpose of this study was to evaluate the usefulness of ASL for detecting interictal temporal hypoperfusion in temporal lobe epilepsy (TLE). ASL-derived CBF measurements were compared with those derived from H215O positron emission tomography (PET). Methods: 11 normal controls and 10 patients with medically intractable TLE were studied. Pulsed ASL (PASL) with quantitative imaging of perfusion using a single subtraction, second version (QUIPSS II) was performed in all subjects and H215O PET was performed in patients. Regional CBF values in the mesial and lateral temporal lobes were measured utilizing quantitative analysis of perfusion images. A perfusion asymmetry index (AI) was calculated for each region. Results: In patients, mean CBF in the mesial temporal lobe was not significantly different between PASL and H215O PET, and ipsilateral mesial temporal CBF was lower than contralateral CBF with both techniques. PASL detected significant mesial temporal perfusion asymmetry agreeing with EEG laterality in four patients. H215O PET found ipsilateral interictal hypoperfusion in three. Both scans found unilateral hypoperfusion in one patient with bilateral EEG discharges. Conclusions: Pulsed ASL may be a promising approach to detecting interictal hypoperfusion in TLE. This method has potential as a clinical alternative to H215O PET due to noninvasiveness and easy accessibility.

Original languageEnglish (US)
Pages (from-to)183-189
Number of pages7
JournalEpilepsy Research
Volume82
Issue number2-3
DOIs
StatePublished - Dec 2008
Externally publishedYes

Keywords

  • Arterial spin labeling
  • Cerebral blood flow
  • HO PET
  • Magnetic resonance imaging
  • Temporal lobe epilepsy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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