Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Wolf, R. L. Articles by Detre, J. A. Search for Related Content PubMed PubMed Citation Articles by Wolf, R. L. Articles by Detre, J. A.

American Journal of Neuroradiology 22:1334-1341 (8 2001)
© 2001 American Society of Neuroradiology

ARTICLE

Detection of Mesial Temporal Lobe Hypoperfusion in Patients with Temporal Lobe Epilepsy by Use of Arterial Spin Labeled Perfusion MR Imaging

Ronald L. Wolf^a, David C. Alsop^a, Igor Levy-Reis^a, Philipp T. Meyer^a, Joseph A. Maldjian^a, Julio Gonzalez-Atavales^a, Jaqueline A. French^a, Abass Alavi^a and John A. Detre^a

^a >>From the Departments of Radiology (R.L.W., D.C.A., P.T.M., J.A.M., A.A.) and Neurology (I.L.-R., J.G.-A., J.A.F., J.A.D.), University of Pennsylvania Medical Center, Philadelphia, PA.

BACKGROUND AND PURPOSE: Interictal hypometabolism has lateralizing value in cases of temporal lobe epilepsy and positive predictive value for seizure-free outcome after surgery to treat epilepsy. Alterations in regional cerebral metabolism can also be inferred from measurements of regional cerebral perfusion. The purpose of this study was to determine the feasibility of detecting cerebral blood flow (CBF) asymmetries in the mesial temporal lobes using continuous arterial spin labeling perfusion MR imaging, which is a noninvasive method for calculating regional CBF.

METHODS: Twelve patients with medically refractory temporal lobe epilepsy who underwent preoperative evaluation for temporal lobectomy and 12 normal control participants were studied retrospectively. Absolute and normalized mesial temporal CBF measurements were compared between the patient and control groups. Lateralization based on a perfusion asymmetry index was compared with metabolic (¹⁸[F]-fluorodeoxyglucose positron emission tomography) and hippocampal volumetric asymmetry indices and with clinical lateralization.

RESULTS: Mesial temporal CBF was more asymmetric in patients with temporal lobe epilepsy than in normal control participants, although asymmetric mesial temporal CBF was also found in normal participants, with the left side dominant. Ipsilateral mesial temporal CBF was significantly decreased compared with contralateral mesial temporal CBF in patients with temporal lobe epilepsy. Global CBF measurements were significantly decreased in patients compared with control participants. Asymmetry in mesial temporal blood flow in patients persisted after normalization to global CBF. Lateralization using continuous arterial spin labeling perfusion MR imaging asymmetry index significantly correlated with lateralization based on ¹⁸[F]-fluorodeoxyglucose positron emission tomography hypometabolism, hippocampal volumes, and clinical evaluation.

CONCLUSION: Continuous arterial spin labeling perfusion MR imaging can detect interictal asymmetries in mesial temporal lobe perfusion in patients with temporal lobe epilepsy. This technique is readily combined with routine structural assessment and potentially offers an inexpensive and noninvasive means of screening for asymmetries in interictal mesial temporal lobe function.

This article has been cited by other articles:

				P. Zhao, D. C. Alsop, A. AbdulJalil, M. Selim, L. Lipsitz, P. Novak, L. Caplan, K. Hu, and V. Novak Vasoreactivity and peri-infarct hyperintensities in stroke Neurology, February 17, 2009; 72(7): 643 - 649. [Abstract] [Full Text] [PDF]

				T. Noguchi, T. Yoshiura, A. Hiwatashi, O. Togao, K. Yamashita, E. Nagao, T. Shono, M. Mizoguchi, S. Nagata, T. Sasaki, et al. Perfusion Imaging of Brain Tumors Using Arterial Spin-Labeling: Correlation with Histopathologic Vascular Density AJNR Am. J. Neuroradiol., April 1, 2008; 29(4): 688 - 693. [Abstract] [Full Text] [PDF]

				P. J. van Laar, Y. van der Graaf, W. P. T. M. Mali, J. van der Grond, and J. Hendrikse Effect of Cerebrovascular Risk Factors on Regional Cerebral Blood Flow Radiology, December 1, 2007; 246(1): 198 - 204. [Abstract] [Full Text] [PDF]

				H. Kimura, H. Takeuchi, Y. Koshimoto, H. Arishima, H. Uematsu, Y. Kawamura, T. Kubota, and H. Itoh Perfusion Imaging of Meningioma by Using Continuous Arterial Spin-Labeling: Comparison with Dynamic Susceptibility-Weighted Contrast-Enhanced MR Images and Histopathologic Features AJNR Am. J. Neuroradiol., January 1, 2006; 27(1): 85 - 93. [Abstract] [Full Text] [PDF]

				J. Hendrikse, M. J. P. van Osch, D. R. Rutgers, C. J. G. Bakker, L. J. Kappelle, X. Golay, and J. van der Grond Internal Carotid Artery Occlusion Assessed at Pulsed Arterial Spin-labeling Perfusion MR Imaging at Multiple Delay Times Radiology, December 1, 2004; 233(3): 899 - 904. [Abstract] [Full Text] [PDF]

				T. F. Floyd, M. McGarvey, E. A. Ochroch, A. T. Cheung, J. A. Augoustides, J. E. Bavaria, M. A. Acker, A. Pochettino, and J. A. Detre Perioperative changes in cerebral blood flow after cardiac surgery: influence of anemia and aging Ann. Thorac. Surg., December 1, 2003; 76(6): 2037 - 2042. [Abstract] [Full Text] [PDF]

				T. F. Floyd, J. M. Clark, R. Gelfand, J. A. Detre, S. Ratcliffe, D. Guvakov, C. J. Lambertsen, and R. G. Eckenhoff Independent cerebral vasoconstrictive effects of hyperoxia and accompanying arterial hypocapnia at 1 ATA J Appl Physiol, December 1, 2003; 95(6): 2453 - 2461. [Abstract] [Full Text]