Accuracy of arterial spin labeling magnetic resonance imaging (MRI) perfusion in detecting the epileptogenic zone in patients with drug-resistant neocortical epilepsy: comparison with electrophysiological data, structural MRI, SISCOM and FDG-PET

European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies
A Sierra-MarcosN Bargalló

Abstract

Locating the epileptogenic zone (EZ) in patients with neocortical epilepsy presents major challenges. Our aim was to assess the accuracy of arterial spin labeling (ASL), an emerging non-invasive magnetic resonance imaging (MRI) perfusion technique, to locate the EZ in patients with drug-resistant neocortical epilepsy. Twenty-five consecutive patients with neocortical epilepsy referred to our epilepsy unit for pre-surgical evaluation underwent a standardized assessment including video-electroencephalography (EEG) monitoring, structural MRI, subtraction ictal single-photon emission computed tomography co-registered to MRI (SISCOM) and fluorodeoxyglucose positron emission tomography (FDG-PET) studies. An ASL sequence was included in the MRI studies. Areas of hypoperfusion or hyperperfusion on ASL were classified into 15 anatomic-functional cortical regions; these regional cerebral blood flow maps were compared with the EZ determined by the other tests and the strength of concordance was assessed with the kappa coefficient. Of the 25 patients [16 (64%) women; mean age 32.4 (±13.8) years], 18 (72%) had lesions on structural MRI. ASL abnormalities were seen in 15 (60%) patients (nine hypoperfusion, six hyperperfusion). ASL had a very...Continue Reading

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Citations

Oct 17, 2017·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·A H V Schapira
Jun 2, 2020·Journal of Neuroscience Research·Tefani PereraUNKNOWN Calgary Comprehensive Epilepsy Program collaborators
Sep 11, 2019·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Oriol PuigIan Law
Apr 19, 2018·EJNMMI Research·Liesbeth De CosterKarolien E Goffin
Oct 21, 2017·Brain : a Journal of Neurology·Ismael Gaxiola-ValdezPaolo Federico

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