title: Identification of cerebral perfusion using arterial spin labeling in patients with seizures in acute settings.
abstract: This study aimed to explore the utility of arterial spin labeling perfusion-weighted imaging (ASL-PWI) in patients with suspected seizures in acute settings. A total of 164 patients who underwent ASL-PWI for suspected seizures in acute settings (with final diagnoses of seizure [n = 129], poststroke seizure [n = 18], and seizure mimickers [n = 17]), were included in this retrospective study. Perfusion abnormality was analyzed for: (1) pattern, (2) multifocality, and (3) atypical distribution against vascular territories. Perfusion abnormality was detected in 39% (50/129) of the seizure patients, most (94%, 47/50) being the hyperperfusion pattern. Of the patients with perfusion abnormality, multifocality or hemispheric involvement and atypical distribution against vascular territory were revealed in 46% (23/50) and 98% (49/50), respectively. In addition, seizures showed characteristic features including hyperperfusion (with or without non-territorial distribution) on ASL-PWI, thus differentiating them from poststroke seizures or seizure mimickers. In patients in whom seizure focus could be localized on both EEG and ASL-PWI, the concordance rate was 77%. The present study demonstrates that ASL-PWI can provide information regarding cerebral perfusion status in patients with seizures in acute settings and has the potential to be used as a non-invasive imaging tool to identify the cerebral perfusion in patients with seizures.
authors.affiliation: Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.|Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Roh-Eul
authors.initials: RE
authors.lastname: Yoo
authors.affiliation: Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.|Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Tae Jin
authors.identifier: http://orcid.org/0000-0001-8441-4574
authors.initials: TJ
authors.lastname: Yun
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Byung-Woo
authors.initials: BW
authors.lastname: Yoon
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Sang Kun
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Soon-Tae
authors.initials: ST
authors.lastname: Lee
authors.affiliation: Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.|Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Koung Mi
authors.initials: KM
authors.lastname: Kang
authors.affiliation: Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.|Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Seung Hong
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.|Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Ji-Hoon
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.|Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Chul-Ho
authors.initials: CH
authors.lastname: Sohn
authors.affiliation: Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.|Department of Radiology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Sun-Won
authors.initials: SW
authors.lastname: Park
authors.affiliation: Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.|Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Moon Hee
authors.initials: MH
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000502:physiology*; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging