title: Usefulness of arterial spin-labeling images in periictal state diagnosis of epilepsy.
abstract: OBJECTIVE
  Arterial spin-labeling (ASL) perfusion MRI, a noninvasive method of assessing cerebral blood flow, is becoming a diagnostic tool of epilepsy. This study was undertaken to evaluate the diagnostic validity of ASL in patients with status epilepticus (SE) in a periictal state.
  
  
  METHODS
  Twenty cases with SE were studied. Patients were imaged at a 3T MRI including ASL and diffusion-weighted imaging (DWI), and were also examined using electroencephalography (EEG). The abnormal findings of ASL were compared with those obtained from DWI and EEG.
  
  
  RESULTS
  Focal hyperperfusion was found in the cortical territory of 13 cases (65%). In 10 of those 13 cases, the ASL hyperperfusion region corresponded to DWI high intensity and EEG abnormality. Two cases showed hyperperfusion corresponding to EEG abnormalities in ASL despite the absence of high intensity in DWI. The remaining single case showed hyperperfusion in ASL despite the absence of high intensity in DWI and EEG abnormalities. Hyperperfusion in the subcortical territory was observed in the ipsilateral thalamus in three cases and in the contralateral cerebellum in one case.
  
  
  CONCLUSIONS
  Our results suggest that ASL is a useful tool to diagnose status epilepticus and localization of the epilepsy focus.
authors.affiliation: Department of Neurology, Suzuka Kaisei Hospital, Mie 513-8505, Japan; Department of Neurology, Graduate School of Medicine, Mie University, Mie 514-8507, Japan. Electronic address: matsuura@kaiseihp.com.
authors.forename: Keita
authors.initials: K
authors.lastname: Matsuura
authors.affiliation: Department of Advanced Diagnostic Imaging, Graduate School of Medicine, Mie University, Mie 514-8507, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Maeda
authors.affiliation: Department of Clinical Laboratory, Kinan Hospital, Mie 519-5293, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Okamoto
authors.affiliation: Department of Neurosurgery, Suzuka Kaisei Hospital, Mie 513-8505, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Araki
authors.affiliation: Department of Neurosurgery, Suzuka Kaisei Hospital, Mie 513-8505, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Miura
authors.affiliation: Department of Neurosurgery, Kuwana West Medical Center, Mie 511-0819, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Hamada
authors.affiliation: Department of Neurosurgery, Suzuka Kaisei Hospital, Mie 513-8505, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kanamaru
authors.affiliation: Department of Neurology, Graduate School of Medicine, Mie University, Mie 514-8507, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Tomimoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013113:Spin Labels
chemical_list: D013113:Spin Labels
keywords: 3T MRI; Arterial spin-labeling; Diaschisis; Epilepsy; MRI; Periictal state