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Temporal lobe epilepsy: presurgical localization with proton chemical shift imaging
1MR Research Center, Cleveland Clinic, OH 44195.
Radiology
|November 1, 1994
Summary
Two-dimensional phase-encoded proton chemical shift imaging effectively identifies the epileptogenic zone in temporal lobe epilepsy (TLE). The N-acetylaspartate/choline ratio (NAA/Cho) is a reliable marker for presurgical localization.
Area of Science:
- Neuroimaging
- Epilepsy Research
- Biochemical Markers
Background:
- Temporal lobe epilepsy (TLE) is a common neurological disorder.
- Accurate presurgical localization of the epileptogenic zone is crucial for successful surgical outcomes.
- Current localization methods have limitations.
Purpose of the Study:
- To evaluate the clinical utility of 2D phase-encoded proton chemical shift imaging for presurgical TLE localization.
- To determine the reliability of biochemical markers in identifying the epileptogenic zone.
Main Methods:
- Chemical shift imaging was performed on 25 TLE patients and 12 healthy volunteers.
- Analysis focused on N-acetylaspartate (NAA), choline (Cho), and creatine (Cr) levels within defined temporal lobe regions of interest.
- Results were compared with electroencephalography (EEG) findings.
Main Results:
- The epileptogenic zone showed decreased NAA and variable Cho/Cr ratios.
- NAA/Cho ratio was the most sensitive and reliable quantitative marker.
- Sensitivity and specificity for detecting the epileptogenic zone were 90% and 85%, respectively, compared to EEG.
Conclusions:
- The NAA/Cho ratio is a highly effective marker for localizing the epileptogenic zone in TLE.
- 2D phase-encoded proton chemical shift imaging shows significant potential for clinical presurgical TLE assessment.