Comparative Lateralizing Ability of Multimodality MRI in Temporal Lobe Epilepsy

Karabekir Ercan, Hediye Pinar Gunbey, Erhan Bilir, Elcin Zan, Halil Arslan
2016 Disease Markers  
Purpose. The objective is to compare lateralizing ability of three quantitative MR (qMRI) modalities to depict changes of hippocampal architecture with clinical entities in temporal lobe epilepsy.Methods. We evaluated 14 patients with clinical and EEG proven diagnosis of unilateral TLE and 15 healthy volunteers. T1-weighted 3D dataset for volumetry, single-voxel1H MR spectroscopy (MRS), and diffusion tensor imaging (DTI) were performed for bilateral hippocampi of all subjects.Results.
more » ... volumetric measurements provided accurate lateralization in 85% of the patients, spectroscopy in 57%, and DTI in 57%. Higher lateralization ratios were acquired combining volumetry-spectroscopy (85%), spectroscopy-DTI (85%), and volumetry-DTI (100%). Significantly decreased NAA/(Cho+Cr) ratios (p=0.002) and increased FA (p=0.001) values were obtained in ipsilateral to epileptogenic hippocampus. Duration of epilepsy and FA values showed a significant negative correlation (p=0.016,r=-0.847). The history of febrile convulsion associated with ipsilateral increased ADC values (p=0.015,r=0.851) and reduced NAA/(Cho+Cr) ratios (p=0.047,r=-761).Conclusion. Volumetry, MRS, and DTI studies provide complementary information of hippocampal pathology. For lateralization of epileptogenic focus and preoperative examination, volumetry-DTI combination may be indicative of diagnostic accuracy.
doi:10.1155/2016/5923243 pmid:27974864 pmcid:PMC5126436 fatcat:3ohwyvztvzafrgeqkalfonshqq