Usefulness of pulsed arterial spin labeling MR imaging in mesial temporal lobe epilepsy.
Usefulness of pulsed arterial spin labeling MR imaging in mesial temporal lobe epilepsy.
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DOI：
10.1016/j.eplepsyres.2008.08.001
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发表时间：
2008-12
影响因子：
2.2
通讯作者：
Theodore, William H.
中科院分区：
文献类型：
--
作者：
Lim, Young-Min;Cho, Yong-Won;Shamim, Sadat;Solomon, Jeffrey;Birn, Rasmus;Luh, Wen Ming;Gaillard, William D.;Ritzl, Eva K.;Theodore, William H.
关键词：
动脉自旋标记(ASL)是一种新兴的磁共振成像(MRI)方法，用于无创测量脑血流量(CBF)。本研究的目的是评价ASL在检测颞叶癫痫(TLE)发作间期颞叶低灌注量方面的作用。ASL的CBF测量结果与H_215O正电子发射断层扫描(PET)的结果进行了比较。11例正常对照和10例难治性TLE患者作为研究对象。所有受试者均行脉冲ASL(PASL)及单次减影定量灌注成像(QUIPSS II)，患者行H_215O正电子发射计算机断层扫描(PET)。利用脑血流灌注图像的定量分析，测量内侧和外侧颞叶的局部CBF值。计算每个区域的灌注不对称指数(AI)。在患者中，PASL和H_215O PET的内侧颞叶CBF平均值无显著差异，但两种技术的同侧内侧颞叶CBF均低于对侧。PASL在4例患者中检测到明显的内侧颞叶血流不对称，与脑电的偏侧性一致。H_215O-PET发现3例同侧发作间期低灌注区。两次扫描均发现1例双侧脑电放电患者单侧低灌注量。脉冲ASL可能是检测TLE发作间期低灌注率的一种有前景的方法。由于非侵入性和易获得，该方法有可能成为临床上H_215O PET的替代方法。
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). 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. 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. 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.
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