Value of Proton-MR-Spectroscopy in the Diagnosis of Temporal Lobe Epilepsy; Correlation of Metabolite Alterations With Electroencephalography
Iranian Journal of Radiology: 9 (1); 1-11
March 25, 2012
Article Type: Research Article
April 3, 2010
December 19, 2011
N A, Kizilgoz
I, et al. Value of Proton-MR-Spectroscopy in the Diagnosis of Temporal Lobe Epilepsy; Correlation of Metabolite Alterations With Electroencephalography,
Iran J Radiol.
Online ahead of Print
Epilepsy, a well-known mostly idiopathic neurologic disorder, has to be
correctly diagnosed and properly treated. Up to now, several diagnostic approaches have
been processed to determine the epileptic focus.
The aim of this study was to discover whether proton-MR-spectroscopic imaging
(MRSI) aids in the diagnosis of temporal lobe epilepsy in conjunction with classical
electroencephalography (EEG) findings.
Patients and Methods:
Totally, 70 mesial temporal zones consisting of 39 right hippocampi
and 31 left hippocampi of 46 patients (25 male, 21 female) were analyzed by proton
MRSI. All patients underwent a clinical neurologic examination, scalp EEG recording and
prolonged video EEG monitoring. Partial seizures on the right, left or both sides were
recorded in all patients. All patients were under medical treatment and none of the patients
underwent amygdalohippocampectomy and similar surgical procedures.
The normal average lactate (Lac), phosphocreatine, N-acetyl aspartate (NAA),
creatine (Cr), choline (Cho), myo-inositol, glutamate and glutamine (Glx) peaks and Nacetyl
aspartate/Cr, NAA/ Cho + Cr, Cho/Cr ratios were measured from the healthy opposite
hippocampi or from the control subjects. The Lac, glutamate and glutamine (Glx),
myo-inositol, phosphocreatine and NAA metabolites plus Cho/Cr ratio showed statistical
difference between the normal and the epileptic hippocampi. Cho, Cr metabolites plus
NAA/Cr, NAA/ Cho + Cr ratios were almost the same between the groups. The sensitivity
of Proton-MR-Spectroscopy for lateralization of the epileptic foci in all patients was 96%
and the specificity was 50%.
Proton-MRSI can easily be considered as an alternative modality of choice
in the diagnosis of temporal lobe epilepsy and in the future; Proton-MR-Spectroscopy
may become the most important technique used in epilepsy centers.
© 2012, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.