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Multimodal Coregistration in Patients with Temporal Lobe Epilepsy—Results of Different Imaging Modalities in Lateralization of the Affected Hemisphere in MR Imaging Positive and Negative Subgroups

M.T. Doelkena, G. Richtera, H. Stefanb, A. Doerflera, A. Noemayrc, T. Kuwertc, O. Ganslandtd, C.H. Nimskyd and T. Hammena,b

a Department of Neuroradiology, University of Erlangen-Nuremberg, Erlangen, Germany
b Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany
c Epilepsy Center (ZEE), Nuclear Medicine, University of Erlangen-Nuremberg, Erlangen, Germany
d Department of Neurosurgery, University of Erlangen-Nuremberg, Erlangen, Germany


Figure 1
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  		Fig 1. Coronal T2 MR imaging revealing increased signal intensity and atrophy of the left hippocampus in a patient with hippocampal sclerosis (arrow).


Figure 2
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  		Fig 2. Coregistration of MR imaging (magnetization-prepared rapid acquisition of gradient echo [A]) and interictal SPECT image (C) for precise anatomic focus localization in a patient with left temporal lobe epilepsy. SPECT displays hypoperfusion in the left mesial temporal lobe (arrow) ipsilateral to atrophy in MR imaging (B).


Figure 3
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  		Fig 3. Example of an interictal SPECT image with problematic changes of relative cerebral blood flow (rCBF) in the right mesial temporal lobe (arrow; A and B). Ictal SPECT elucidates hyperperfusion in the hippocampus (arrow; C and D).





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X