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Pilot study of the utility of diffusion tensor magnetic resonance imaging in lateralising non-lesional temporal lobe epilepsy.

Cassandra E. Szoeke 1Terence O Brien 1Patricia Desmond 2

1. The Univeristy of Melbourne (UNIMELB), Grattan Street, Melbourne 3052, Australia
2. The Royal Melbourne Hospital (RMH), Grattan, Melbourne 3052, Australia


Approximately 40% of patients with medically refractory non-lesional Temporal Lobe Epilepsy (TLE) are not lateralised with current structural MRI techniques including volumetric analysis and T2 mapping. Diffusion tensor (DT) MRI is a relatively new MRI technology that has potential to detect functional abnormalities in patients with normal structural MRI.

To perform a pilot study to assess the potential for DT MRI to lateralise non-lesional TLE.

Seven patients with non-lesional TLE (four with hippocampal sclerosis (HS) and four without HS on structural MRI), and well lateralised seizures on ictal-EEG were studied with DT MRI (1.5 Tesla, GE system) performed in 25 directions with b value: 1500 s/mm . The tensor signal was quantitated for voxels placed over the hippocampus and anterior temporal pole bilaterally and the side-to-side ratios correlated with the ictal EEG lateralisation.

The tensor signal was higher on the epileptogenic side for the hippocampal voxels in 4/7 (71%) of patients, and for the anterior temporal voxels in 4/7 (51%) of patients.

Fractional anisotropy shows a trend to be decreased in the hippocampus ipsilateral to the EEG lateralization. Quantitation of ADC with DT signal in the hippocampal region shows promise for lateralising non-lesional TLE in this pilot study, but further patients and correlation with surgical outcome is required before its role is established.


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Presentation: poster at E-MRS Fall Meeting 2004, Symposium D, by Cassandra E. Szoeke
See On-line Journal of E-MRS Fall Meeting 2004

Submitted: 2004-08-18 12:04
Revised:   2009-06-08 12:55