Application of high field spectroscopic imaging in the evaluation of temporal lobe epilepsy

H. P. Hetherington, R. I. Kuzniecky, J. W. Pan, J. T. Vaughan, D. B. Tweig, G. M. Pohost

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Previous spectroscopic imaging studies of temporal lobe epilepsy have used comparisons of metabolite content or ratios to lateralize the seizure focus. Although highly successful, these studies have shown significant variations within each of the groups of healthy subjects and patients. This variation may arise from the natural differences seen in metabolite concentration in gray and white matter, the complex anatomy seen about the hippocampus, and the large voxels typically employed at 1.5 T. Using a 4.1 T whole body system, we have acquired spectroscopic images with 0.5 cc nominal voxels (1 cc after filtering) to evaluate the regional variation in metabolite content of the hippocampus, temporal gray and white matter, midbrain, and cerebellar vermis. Using a threshold value of 0.90 for CR/NAA, a value 90% of all normal hippocampal voxels lay below, we have correctly identified the presence of epileptogenic tissue in patients with unilateral as well as bilateral seizures. By using comparisons to healthy values of the CR/NAA ratio, this method enables the visualization of bilateral disease and provides information on the extent of gray matter involvement.

Original languageEnglish (US)
Pages (from-to)1175-1180
Number of pages6
JournalMagnetic Resonance Imaging
Volume13
Issue number8
DOIs
StatePublished - 1995
Externally publishedYes

Bibliographical note

Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.

Keywords

  • Creatine
  • Epilepsy
  • N-acetyl aspartate
  • Spectroscopic imaging

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