1H NMR CHEMICAL SHIFT IMAGING IN TEMPORAL LOBE EPILEPSY

描述：(改编自申请者摘要)癫痫是 最常见的神经系统疾病，影响100至200万人 美国人。对于大约10-20万美国人来说，它的衰弱症状 不能通过药物治疗来克服。在其中一些患者中， 手术是非常有效的，但可以进行非侵入性诊断 MRI、PET和头皮EEG等程序可提供诊断定位 在不到70%的部分癫痫患者中。 颅内脑电测量虽然非常准确，但具有侵入性， 需要住院治疗，而且费用高昂。然而，磁共振波谱学 用N-乙酰天冬氨酸(NA)/肌酸(CR)比值进行检查 最近被证明在偏侧致痫方面非常有效 组织。这些研究使用了NA/CR比率的不对称性 以颞叶作为确定癫痫灶的标准。 不幸的是，这种类型的分析排除了使用该测试来： 1)评估患者是否有双侧疾病的证据，2)确定 疾病的空间范围和3)决定哪些化合物是 实际正在更改(CR或NA或两者都有)。因此，这样做的目标是 建议：1)推广、应用和评估1H-CSI方法 允许根据绝对值定位癫痫发作焦点 与从健康组织中确定的参数进行比较，从而 允许评估双侧疾病的存在；2)确定 所见比率变化的起因3)评估其他 代谢参数，特别是谷氨酸和谷氨酰胺含量 癫痫灶定位的指标和4)评估 这些方法与头皮脑电比较的敏感性和特异性 1.5T磁共振成像。这些研究总体上将在4.1T下进行 身体成像/光谱系统。尽管这些系统的数量 都极其有限，在优势方面加大了S/N、空间 分辨率和光谱分辨率，使其成为一种有吸引力的工具 调查这些变化。对该方法的成功验证 以及随后向较低场强的转换，将提供 一种高精度、非侵入性和经济高效的预诊断机制 外科手术计划。

DESCRIPTION: (adapted from Applicant's Abstract) Epilepsy is one of the most common neurological disorders, affecting one to two million Americans. For some 100,000-200,000 Americans its debilitating symptoms cannot be overcome through medication. In some of these patients, surgery is highly effective, however available non-invasive diagnostic procedures such as MRI, PET and scalp EEG provide diagnostic localization in less than 70 percent of the patients with partial seizures. Intracranial EEG measurements while highly accurate are invasive, require hospitalization and are costly. However MR spectroscopy examinations using the ratio of N-acetyl aspartate (NA)/creatine (CR) have recently proven to be highly effective in lateralizing epileptogenic tissue. These studies have used asymmetries in the NA/CR ratio between the temporal lobes as the criteria for determining the seizure focus. Unfortunately this type of analysis precludes the use of this test to: 1) evaluate the patient for evidence of bilateral disease, 2) determine the spatial extent of the disease and 3) determine which compounds are actually changing (CR or NA or both). Therefore the goal of this proposal is to: 1) extend, apply and evaluate 1H CSI methods which permit the localization of the seizure focus based on absolute comparisons to parameters determined from healthy tissue, thereby permitting evaluation of the presence of bilateral disease; 2) determine the origin of the ratio changes seen 3) evaluate the use of other metabolic parameters, specifically glutamate and glutamine content as indicators for the localization of the seizure focus and 4) evaluate the sensitivity and specificity of these methods in comparison to scalp EEG and MRI at 1.5T. These studies will be performed at 4.1T on a whole body imaging/spectroscopy system. Although the number of these systems are extremely limited, the advantages in terms of increased S/N, spatial resolution and spectral resolution, makes it an attractive tool for investigating these changes. Successful validation of this methodology and its subsequent translation to lower field strengths, would provide a highly accurate, non-invasive and cost effective mechanism for pre- surgical planning.