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1H MR spectroscopic imaging in patients with MRI-negative extratemporal epilepsy: correlation with ictal onset zone and histopathology

Pavel Krsek, Milan Hajek, Monika Dezortova, Filip Jiru, Antonin Skoch, Petr Marusic, Josef Zamecnik, Martin Kyncl, Michal Tichy, Vladimir Komarek

. 2007 ; 17 (8) : 2126-2135.

Jazyk angličtina Země Německo

Perzistentní odkaz   https://www.medvik.cz/link/bmc10010928

Grantová podpora
NR8843 MZ0 CEP - Centrální evidence projektů

Digitální knihovna NLK
Plný text - Článek
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E-zdroje Online

NLK ProQuest Central od 1997-01-01 do 2017-12-31
Medline Complete (EBSCOhost) od 2000-01-01 do Před 1 rokem
Nursing & Allied Health Database (ProQuest) od 1997-01-01 do 2017-12-31
Health & Medicine (ProQuest) od 1997-01-01 do 2017-12-31

Odkazy

Knihovny.cz E-zdroje

Proton magnetic resonance spectroscopy ((1)H MRS) is beneficial in the lateralization of the epileptogenic zone in temporal lobe epilepsy; however, its role in extratemporal and, especially, MRI-negative epilepsy has not been established. This study seeks to verify how (1)H MRS could help in localizing the epileptogenic zone in patients with MRI-negative extratemporal epilepsy. Seven patients (8-23 years) with MRI-negative refractory focal epilepsy were studied using (1)H MRS on a 1.5T MR system. Chemical shift imaging sequence in the transversal plane was directed towards the suspected epileptogenic zone localized by seizure semiology, scalp video/EEG, ictal SPECT and (18)FDG-PET. Spectra were evaluated using the program CULICH, and the coefficient of asymmetry was used for quantitative lateralization. MRS detected lateralization in all patients and was able to localize pathology in five. The most frequent findings were decreased ratios of N-acetylaspartate to choline compounds characterized by increasing choline concentration. The localization of the (1)H MRS abnormality correlated well with ictal SPECT and subdural mapping. In all cases, histopathological analysis revealed MRI-undetected focal cortical dysplasias. (1)H MRS could be more sensitive for the detection of discrete malformations of cortical development than conventional MRI. It is valuable in the presurgical evaluation of patients without MRI-apparent lesions.

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$a Proton magnetic resonance spectroscopy ((1)H MRS) is beneficial in the lateralization of the epileptogenic zone in temporal lobe epilepsy; however, its role in extratemporal and, especially, MRI-negative epilepsy has not been established. This study seeks to verify how (1)H MRS could help in localizing the epileptogenic zone in patients with MRI-negative extratemporal epilepsy. Seven patients (8-23 years) with MRI-negative refractory focal epilepsy were studied using (1)H MRS on a 1.5T MR system. Chemical shift imaging sequence in the transversal plane was directed towards the suspected epileptogenic zone localized by seizure semiology, scalp video/EEG, ictal SPECT and (18)FDG-PET. Spectra were evaluated using the program CULICH, and the coefficient of asymmetry was used for quantitative lateralization. MRS detected lateralization in all patients and was able to localize pathology in five. The most frequent findings were decreased ratios of N-acetylaspartate to choline compounds characterized by increasing choline concentration. The localization of the (1)H MRS abnormality correlated well with ictal SPECT and subdural mapping. In all cases, histopathological analysis revealed MRI-undetected focal cortical dysplasias. (1)H MRS could be more sensitive for the detection of discrete malformations of cortical development than conventional MRI. It is valuable in the presurgical evaluation of patients without MRI-apparent lesions.
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