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Interictal arterial spin-labeling MRI perfusion in intractable epilepsy
N Pendse1, M Wissmeyer, S Altrichter
1Department of Neuroradiology, Geneva University Hospital, Switzerland.
Introduction:
Magnetic resonance imaging (MRI) is required for the investigation of surgically intractable epilepsy. In addition to the standard MRI techniques, perfusion sequences can be added to improve visualization of underlying pathological changes. Arterial spin-labeling (ASL) MRI perfusion does not require contrast administration and, for this reason, may have advantages in these patients.
Methods:
We report here on 16 patients with epilepsy who underwent MRI of the brain with ASL and positron emission tomography (PET).
Results:
Despite a slightly reduced resolution with ASL, we found a correlation between ASL, PET and electrophysiological data, with hypoperfusion on ASL that corresponded with hypoperfusion on interictal PET.
Conclusion:
Given the correlation between ASL and PET and electrophysiology, perfusion with ASL could become part of the standard work-up in patients with epilepsy.
Insights
Arterial spin-labeling (ASL) MRI perfusion imaging shows promise for epilepsy evaluation. ASL findings correlate with positron emission tomography (PET) and electrophysiology, suggesting its utility in diagnosing epilepsy.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Epilepsy diagnosis often requires Magnetic Resonance Imaging (MRI).
- Perfusion sequences enhance MRI by visualizing pathological changes.
- Arterial spin-labeling (ASL) MRI offers contrast-free perfusion imaging, beneficial for certain patient groups.
Purpose of the Study:
- To evaluate the utility of ASL MRI perfusion in patients with epilepsy.
- To compare ASL MRI findings with positron emission tomography (PET) and electrophysiological data.
Main Methods:
- 16 patients with epilepsy underwent brain MRI with ASL and PET.
- ASL and PET data were analyzed for perfusion abnormalities.
Main Results:
- ASL MRI demonstrated slightly reduced resolution compared to other methods.
- A correlation was found between ASL, PET, and electrophysiological data.
- Hypoperfusion on ASL corresponded with hypoperfusion on interictal PET scans.
Conclusions:
- ASL MRI perfusion shows a correlation with PET and electrophysiology in epilepsy patients.
- ASL perfusion imaging may be a valuable addition to the standard epilepsy work-up.
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