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Spectroscopic Metabolic Abnormalities in mTLE with and without MRI Evidence for Mesial Temporal Sclerosis Using Hippocampal Short‐TE MRSI
Author(s) -
Mueller Susanne G.,
Laxer Kenneth D.,
Suhy Joyce,
Lopez Ria C.,
Flenniken Derek L.,
Weiner Michael W.
Publication year - 2003
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1046/j.1528-1157.2003.50202.x
Subject(s) - hippocampal sclerosis , temporal lobe , epilepsy , mesial temporal lobe epilepsy , hippocampus , magnetic resonance imaging , hippocampal formation , magnetic resonance spectroscopic imaging , lateralization of brain function , neuroimaging , medicine , neuroscience , psychology , nuclear medicine , radiology
Summary: Purpose: Long echo time (TE) spectroscopy reliably identifies the epileptogenic hippocampus in mesial temporal lobe epilepsy. Short‐TE spectroscopy gives additional metabolic information but may have more artifacts. The aim of this study was to test (a) lateralization of the seizure focus by short‐TE spectroscopy, and (b) value of myoinositol (MI) in the identification of the epileptogenic hippocampus. Methods: Twenty‐four patients with temporal lobe epilepsy: 16 with mesial temporal sclerosis (TLE‐MTS), eight patients with normal magnetic resonance imaging (MRI; TLE‐No), and 16 controls were studied with hippocampal 2D short‐TE magnetic resonance spectroscopic imaging (MRSI). Results: In TLE‐MTS, the ipsilateral N ‐acetylaspartate (NAA) was decreased compared with contralateral (p = 0.03) or controls (p = 0.007) . Additionally, the ipsilateral MI was decreased compared with controls (p = 0.012) . TLE‐No values showed no side differences and were not different from controls. Abnormalities in the anterior hippocampus correctly lateralized the epileptogenic hippocampus in ≤82% of TLE‐MTS and in ≤80% of the TLE‐No. Conclusions: The accuracy of short‐TE MRSI at 1.5 T for focus lateralization in mTLE is comparable to that of long‐TE MRSI. MI might be helpful for focus lateralization, but more information about the factors influencing the MI concentration is needed.