Identification of the epileptogenic lobe in neocortical epilepsy with proton MR spectroscopic imaging.

摘要: Summary: Purpose: The aim of this study was to evaluate the usefulness multislice magnetic resonance spectroscopic imaging (MRSI) in combination with tissue segmentation for identification epileptogenic focus neocortical epilepsy (NE). Methods: Twenty patients NE (10 MRI-visible malformations, 10 normal MRI) and 19 controls were studied. In controls, N-acetylaspartate NAA/Cr NAA/Cho all voxels a given lobe expressed as function white matter, thresholds determined by calculating 95% prediction intervals (PIs) NAA/Cho. Voxels or values less than PI defined “pathological.” Z-scores calculated. Depending on magnitude those z-scores, we used two different methods (score-localization forced-localization) identify subject highest percentage pathological voxels, which supposed represent lobe. Results: MRSI correctly identified containing EEG 65% patients. localization correct 70% an malformation 60% MRI. Of patients, 15% had metabolically abnormal brain regions outside lobe, 35% evidence secondary hippocampal damage. Conclusions: may be helpful even