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AJNR - American Journal of Neuroradiology

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Multisection Proton MR Spectroscopy for Mesial Temporal Lobe Epilepsy

Arístides A. Capizzano^a,c, Peter Vermathen^a, Kenneth D. Laxer^b, Gerald B. Matson^a, Andrew A. Maudsley^a, Brian J. Soher^a, Norbert W. Schuff^a,c and Michael W. Weiner^a,b,c,d,e

^a Department of Veterans Affairs Medical Center, Magnetic Resonance Spectroscopy Unit, University of California, San Francisco, San Francisco, CA
^b Department of Neurology, University of California, San Francisco, San Francisco, CA
^c Department of Radiology, University of California, San Francisco, San Francisco, CA
^d Department of Medicine, University of California, San Francisco, San Francisco, CA
^e Department of Psychiatry, University of California, San Francisco, San Francisco, CA

View larger version (85K): [in a new window]   FIG 1. Parasagittal scout MR images. A, Section positioning of the PRESS sequence. B, Multisection 1H-MRS imaging sequence.

View larger version (114K): [in a new window]   FIG 2. Oblique axial proton density–weighted image corresponding to the temporal section of the multisection 1H-MRS sequence of a patient with right mTLE shows regions for voxel selection: 1, insula; 2, temporal operculum; 3, lateral temporal cortex; 4, hippocampal body; 5, cerebellar hemisphere.

View larger version (31K): [in a new window]   FIG 3. Scout axial MR image (center) for PRESS sequence, encompassing both hippocampi. Spectra from right and left hippocampus are shown with NAA reduction on the left side in this case of left mTLE. a.u., absolute units.

View larger version (51K): [in a new window]   FIG 4. NAA metabolite images obtained in a control subject. A, Ventricular section (note the low signal intensity from the lateral ventricles). B, Supraventricular section as defined on sagittal scout images (see Fig 1B).

View larger version (109K): [in a new window]   FIG 5. NAA metabolite image of a left mTLE shows reduced NAA signal intensity on the anterior left temporal lobe.