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  • Title: Application of dynamic susceptibility contrast-enhanced perfusion in temporal lobe epilepsy.
    Author: Xing W, Wang X, Xie F, Liao W.
    Journal: Acta Radiol; 2013 Feb 01; 54(1):107-12. PubMed ID: 23117196.
    Abstract:
    BACKGROUND: Accurately locating the epileptogenic focus in temporal lobe epilepsy (TLE) is important in clinical practice. Single-photon emission computed tomography (SPECT) and positron-emission tomography (PET) have been widely used in the lateralization of TLE, but both have limitations. Magnetic resonance perfusion imaging can accurately and reliably reflect differences in cerebral blood flow and volume. PURPOSE: To investigate the diagnostic value of dynamic susceptibility contrast-enhanced (DSC) perfusion magnetic resonance imaging (MRI) in the lateralization of the epileptogenic focus in TLE. MATERIAL AND METHODS: Conventional MRI and DSC-MRI scanning was performed in 20 interictal cases of TLE and 20 healthy volunteers. The relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) of the bilateral mesial temporal lobes of the TLE cases and healthy control groups were calculated. The differences in the perfusion asymmetry indices (AIs), derived from the rCBV and rCBF of the bilateral mesial temporal lobes, were compared between the two groups. RESULTS: In the control group, there were no statistically significant differences between the left and right sides in terms of rCBV (left 1.55 ± 0.32, right 1.57 ± 0.28) or rCBF (left 99.00 ± 24.61, right 100.38 ± 23.46) of the bilateral mesial temporal lobes. However, in the case group the ipsilateral rCBV and rCBF values (1.75 ± 0.64 and 96.35 ± 22.63, respectively) were markedly lower than those of the contralateral side (2.01 ± 0.79 and 108.56 ± 26.92; P < 0.05). Both the AI of the rCBV (AI(rCBV); 13.03 ± 10.33) and the AI of the rCBF (AI(rCBF); 11.24 ± 8.70) of the case group were significantly higher than that of the control group (AI(rCBV) 5.55 ± 3.74, AI(rCBF) 5.12 ± 3.48; P < 0.05). The epileptogenic foci of nine patients were correctly lateralized using the 95th percentile of the AI(rCBV) and AI(rCBF) of the control group as the normal upper limits. CONCLUSION: In patients with TLE interictal, both rCBV and rCBF of the ipsilateral mesial temporal lobe were markedly lower than that of healthy control subjects. DSC-MRI can provide lateralization for TLE.
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