Usefulness of arterial spin labeling perfusion as an initial evaluation of status epilepticus.
Usefulness of arterial spin labeling perfusion as an initial evaluation of status epilepticus.
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DOI：
10.1038/s41598-021-03698-7
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发表时间：
2021-12-20
影响因子：
4.6
通讯作者：
Choi JY
中科院分区：
文献类型：
--
作者：
Kim TJ;Choi JW;Han M;Kim BG;Park SA;Huh K;Choi JY
本研究旨在评估动脉自旋标记（ASL）在一大组癫痫持续状态（SE）患者中的敏感性和预后价值，并将其与其他磁共振（MR）序列（包括动态敏感性对比（DSC）灌注成像）进行比较。我们回顾性收集了2016年9月至2020年3月在三级中心的SE患者的数据。对MR图像进行视觉评估，并比较多延迟ASL、DSC、流体衰减反转恢复（FLAIR）和扩散加权成像（DWI）对SE检测和预后的敏感性。我们纳入51例SE患者和46例自限性癫痫患者进行比较。90.2% (46/51) SE患者ASL有相关改变，高于DSC、FLAIR和DWI。ASL是早期区分SE和自限性癫痫发作最敏感的方法。ASL检测难治性SE（89.5%）或估计不良结局（100%）的敏感性高于其他MR方案或脑电图，与临床预后评分相当，尽管ASL的特异性非常低，分别为9.4%和15.6%。ASL对SE的检测和预测预后的能力优于其他MR序列，对SE患者的初步评估具有一定的价值。
This study aimed to evaluate the sensitivity and prognostic value of arterial spin labeling (ASL) in a large group of status epilepticus (SE) patients and compare them with those of other magnetic resonance (MR) sequences, including dynamic susceptibility contrast (DSC) perfusion imaging. We retrospectively collected data of patients with SE in a tertiary center between September 2016 and March 2020. MR images were visually assessed, and the sensitivity for the detection of SE and prognostication was compared among multi-delay ASL, DSC, fluid-attenuated inversion recovery (FLAIR), and diffusion-weighted imaging (DWI). We included 51 SE patients and 46 patients with self-limiting seizures for comparison. Relevant changes in ASL were observed in 90.2% (46/51) of SE patients, a percentage higher than those for DSC, FLAIR, and DWI. ASL was the most sensitive method for initial differentiation between SE and self-limiting seizures. The sensitivity of ASL for detecting refractory SE (89.5%) or estimating poor outcomes (100%) was higher than those of other MR protocols or electroencephalography and comparable to those of clinical prognostic scores, although the specificity of ASL was very low as 9.4% and 15.6%, respectively. ASL showed a better ability to detect SE and predict the prognosis than other MR sequences, therefore it can be valuable for the initial evaluation of patients with SE.
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