Capability of arterial spin labeling MR imaging in localizing seizure focus in clinical seizure activity
Capability of arterial spin labeling MR imaging in localizing seizure focus in clinical seizure activity
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DOI：
10.1016/j.ejrad.2016.04.015
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发表时间：
2016-07-01
影响因子：
3.3
通讯作者：
Sohn, Chul-Ho
中科院分区：
文献类型：
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作者：
Kim, Beom Su;Lee, Soon-Tae;Sohn, Chul-Ho
目的：本研究的目的是评估脑血流量使用动脉自旋标记（ASL）灌注磁共振（MR）成像在临床癫痫发作活动的患者，并确定其诊断性能，在识别癫痫focus.Materials和方法：机构审查委员会批准了我们医院的回顾性研究。放弃知情同意。由神经科医生根据癫痫症状学、脑电图和常规成像方式确定临床癫痫病灶。结果：ASL灌注成像对临床发作病灶的定位率为95%（42/44），对临床发作病灶的定位率为95%（42/44）。ASL灌注MR成像对癫痫病灶识别的敏感性和特异性为74%（95% CI：58%，86%）（42名患者中有31名患者的临床癫痫发作病灶可定位，其中10名患者完全一致，21名患者部分一致）和0%（95% CI：0%，84%）（对于临床癫痫灶无法定位的2例患者，通过ASL灌注MR成像确定）。因此，ASL灌注MR成像定位癫痫灶的总体准确性为70%（33/44）。4例ASL灌注异常的患者，其ASL灌注成像的癫痫灶与临床癫痫灶不一致。结论：ASL灌注成像可提供临床癫痫活动患者的灌注状态信息，为临床癫痫灶定位提供重要的诊断线索。它有可能作为一种非侵入性的补充诊断工具，为患者的临床癫痫发作活动。(C)2016爱思唯尔爱尔兰有限公司版权所有。
Purpose: The purpose of this study was to evaluate cerebral blood flow using arterial spin labeling (ASL) perfusion magnetic resonance (MR) imaging in patients with clinical seizure activity and determine its diagnostic performance in identifying seizure focus.Materials and methods: Institutional Review Board of our hospital approved this retrospective study. Informed consent was waived. Clinical seizure focus was determined by a neurologist based on seizure semiology, electroencephalography, and conventional imaging modalities. The diagnostic performance of ASL perfusion MR imaging to identifying seizure focus compared to clinical seizure focus was analyzed.Results: Clinical seizure focus was localized in 95% (42/44) of patients. The sensitivity and specificity of ASL perfusion MR imaging for identifying seizure focus were 74% (95% CI: 58%, 86%) (clinical seizure focus was localizable in 31 of 42 patients, including complete concordance in 10 patients and partial concordance in 21 patients) and 0% (95% CI: 0%, 84%) (for the two patients whose clinical seizure foci were not localizable, they were identified by ASL perfusion MR imaging), respectively. Thus, the overall accuracy of ASL perfusion MR imaging for localizing seizure focus was 70% (33/44). For 4 patients who had abnormal perfusion on ASL, their seizure foci based on ASL perfusion MR imaging were discordant with clinical seizure foci.Conclusion: ASL perfusion MR imaging can provide information about perfusion status and important diagnostic clue in localizing seizure focus in patients with clinical seizure activity. It has the potential as a non-invasive complementary diagnostic tool for patients with clinical seizure activity. (C) 2016 Elsevier Ireland Ltd. All rights reserved.