title: Comparative Lateralizing Ability of Multimodality MRI in Temporal Lobe Epilepsy.
abstract: Purpose. The objective is to compare lateralizing ability of three quantitative MR (qMRI) modalities to depict changes of hippocampal architecture with clinical entities in temporal lobe epilepsy.Methods. We evaluated 14 patients with clinical and EEG proven diagnosis of unilateral TLE and 15 healthy volunteers. T1-weighted 3D dataset for volumetry, single-voxel1H MR spectroscopy (MRS), and diffusion tensor imaging (DTI) were performed for bilateral hippocampi of all subjects.Results. Individual volumetric measurements provided accurate lateralization in 85% of the patients, spectroscopy in 57%, and DTI in 57%. Higher lateralization ratios were acquired combining volumetry-spectroscopy (85%), spectroscopy-DTI (85%), and volumetry-DTI (100%). Significantly decreased NAA/(Cho+Cr) ratios (p= 0.002) and increased FA (p= 0.001) values were obtained in ipsilateral to epileptogenic hippocampus. Duration of epilepsy and FA values showed a significant negative correlation (p= 0.016,r= -0.847). The history of febrile convulsion associated with ipsilateral increased ADC values (p= 0.015,r= 0.851) and reduced NAA/(Cho+Cr) ratios (p= 0.047,r= -761).Conclusion. Volumetry, MRS, and DTI studies provide complementary information of hippocampal pathology. For lateralization of epileptogenic focus and preoperative examination, volumetry-DTI combination may be indicative of diagnostic accuracy.
authors.affiliation: Radiology Department, Ataturk Training Research Hospital, Ankara, Turkey.
authors.forename: Karabekir
authors.initials: K
authors.lastname: Ercan
authors.affiliation: Radiology Department, Ondokuz Mayıs University, Samsun, Turkey.
authors.forename: Hediye Pinar
authors.identifier: 0000-0001-5288-5590
authors.initials: HP
authors.lastname: Gunbey
authors.affiliation: Neurology Department, Gazi University, Ankara, Turkey.
authors.forename: Erhan
authors.initials: E
authors.lastname: Bilir
authors.affiliation: Radiology Department, Johns Hopkins Medical Institution, Baltimore, MD, USA.
authors.forename: Elcin
authors.initials: E
authors.lastname: Zan
authors.affiliation: Radiology Department, Ataturk Training Research Hospital, Ankara, Turkey.
authors.forename: Halil
authors.initials: H
authors.lastname: Arslan
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D056324:Diffusion Tensor Imaging / Q000379:methods*; D004833:Epilepsy, Temporal Lobe / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D055815:Young Adult