Diagnostic usefulness of arterial spin labeling in MR negative children with new onset seizures
Diagnostic usefulness of arterial spin labeling in MR negative children with new onset seizures
复制标题
DOI：
10.1016/j.seizure.2019.01.024
复制
发表时间：
2019-02-01
影响因子：
3
通讯作者：
Lee, Yun Jeong
中科院分区：
文献类型：
--
作者：
Lee, So Mi;Kwon, Soonhak;Lee, Yun Jeong
目的：动脉脊柱标记（ASL）磁共振成像（MRI）是一种非侵入性脑血流测量方法，可以定位癫痫患者的癫痫发作病灶。本研究的目的是确定其效用定位癫痫发作的儿童没有结构性病变的MRI。方法：43个连续的儿童进行脑电图（EEG）和结构MRI，沿着ASL评估新开发的癫痫发作，被纳入。ASL异常被归类为低/高灌注，根据视觉评估，并与癫痫发作的重点确定的临床信息和EEG.Results：在43例（男性17：F 26，平均年龄，6.3 +/- 3.3岁），癫痫发作类型是局灶性的36例和7例患者全身。25例（58.1%）患者出现灌注改变。在36例局灶性癫痫患者中，24例（66.7%）ASL异常，19例（52.8%）ASL与临床病灶一致。在7例全身性癫痫发作患者中，仅1例患者显示ASL异常。总体一致性显示中度一致性（k = 0.542）。在癫痫发作后一天内获得ASL是与两者之间一致性的唯一显著相关因素（p = 0. 05）。结论：据我们所知，这是第一项评估ASL MRI在MR阴性儿童新发癫痫发作中帮助定位癫痫病灶的有效性的研究。ASL与EEG和结构MRI的联合应用可能在儿童癫痫的评估中发挥重要作用。
Purpose: Arterial spine labeling (ASL) magnetic resonance imaging (MRI) is the non-invasive measurement of cerebral blood flow that can localize the seizure focus in patients with epilepsy. The aim of this study was to identify its utility for localizing the seizure focus in children with no structural lesion on MRI.Methods: Forty-three consecutive children who underwent electroencephalography (EEG) and structural MRI, along with ASL for evaluation of newly developed seizures, were included. ASL abnormalities were classified as hypo/hyperperfusion, based on visual assessment, and compared with the seizure focus determined by clinical information and EEG.Results: Among the 43 patients (M 17: F 26, mean age, 6.3 +/- 3.3 years), the seizure type was focal in 36 patients and generalized in seven patients. Twenty-five (58.1%) patients showed perfusion change. Out of 36 patients with focal seizure, 24 (66.7%) showed ASL abnormalities, and 19 (52.8%) showed concordance between ASL and clinical focus. Out of seven patients with generalized seizure, only one patient showed ASL abnormalities. The overall concordance revealed moderate agreement (k = 0.542). ASL acquisition within one day from seizure onset was the only significant associating factor with the concordance between the two (p = 0. 014).Conclusion: To our knowledge, this is the first study to assess the usefulness of ASL MRI to assist in localizing the seizure focus in MR-negative children with new onset seizures. The combined use of ASL with EEG and structural MRI may play an important role in the evaluation of pediatric epilepsy.