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Value of single-voxel proton MR spectroscopy in temporal lobe epilepsy

Eric Achten UGent, Paul Boon UGent, Tom Van de Kerckhove, Jacques Caemaert UGent, Jacques De Reuck UGent and Marc Kunnen UGent (1997) AMERICAN JOURNAL OF NEURORADIOLOGY. 18(6). p.1131-1139
abstract
PURPOSE: To study the value of different parameters derived from single-voxel proton MR spectroscopy of the mesial temporal lobes in the lateralization of the epileptogenic zone in patients with temporal lobe epilepsy, METHODS: We studied 12 healthy volunteers and 21 patients with temporal lobe epilepsy refractory to medical treatment, which was clearly lateralized with electroencephalography (EEG) and MR imaging, The mesial temporal lobes were investigated with single-voxel proton MR spectroscopy using a point-resolved spectroscopic sequence with an echo time of 135 milliseconds, The normalized concentration of N-acetylaspartate (NAA), creatine (Cr), and choline-containing compounds (Cho), and the metabolite ratios NAA/Cho+Cr, NAA/Cr, Cho/Cr, and NAA/Cho were calculated from the spectra. Using these values and an asymmetry index, we assigned the patients to one of five lateralization categories, RESULTS: The most consistent MR spectroscopic parameter for clear lateralization was the NAA/Cho+Cr ratio, followed by the NAA ratio, But with an adequate asymmetry index, the epilepsy in 17 (81%) of 21 patients could be lateralized by EEC and MR imaging with both parameters concordantly. Symmetric bilateral abnormalities were found in four of the 21 patients with NAA/Cho+Cr and in only one of the 21 patients with NAA. With both parameters, no contradictory lateralization was found; however, this was indeed the case with the remaining ratios, NAH/Cr, Cho/Cr, and NAA/Cho, in two, three, and one of the patients, respectively. A statistically significant decrease in NAA was found on the epileptic side, but also on the contralateral side. CONCLUSION: With an adequate asymmetry index, NAA/Cho+Cr and NAA are equally sensitive in predicting the side of involvement in patients with unilateral temporal lobe epilepsy.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
spectroscopy, magnetic resonance, seizures, MAGNETIC-RESONANCE SPECTROSCOPY, PRESURGICAL EVALUATION, H-1-NMR SPECTROSCOPY, EXTRACTS, ORIGIN, INVIVO
journal title
AMERICAN JOURNAL OF NEURORADIOLOGY
Am. J. Neuroradiol.
volume
18
issue
6
pages
1131 - 1139
Web of Science type
Article
ISSN
0195-6108
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
669232
handle
http://hdl.handle.net/1854/LU-669232
alternative location
http://www.ajnr.org/cgi/content/abstract/18/6/1131
date created
2009-05-27 14:52:59
date last changed
2010-04-27 14:10:55
@article{669232,
  abstract     = {PURPOSE: To study the value of different parameters derived from single-voxel proton MR spectroscopy of the mesial temporal lobes in the lateralization of the epileptogenic zone in patients with temporal lobe epilepsy, METHODS: We studied 12 healthy volunteers and 21 patients with temporal lobe epilepsy refractory to medical treatment, which was clearly lateralized with electroencephalography (EEG) and MR imaging, The mesial temporal lobes were investigated with single-voxel proton MR spectroscopy using a point-resolved spectroscopic sequence with an echo time of 135 milliseconds, The normalized concentration of N-acetylaspartate (NAA), creatine (Cr), and choline-containing compounds (Cho), and the metabolite ratios NAA/Cho+Cr, NAA/Cr, Cho/Cr, and NAA/Cho were calculated from the spectra. Using these values and an asymmetry index, we assigned the patients to one of five lateralization categories, RESULTS: The most consistent MR spectroscopic parameter for clear lateralization was the NAA/Cho+Cr ratio, followed by the NAA ratio, But with an adequate asymmetry index, the epilepsy in 17 (81\%) of 21 patients could be lateralized by EEC and MR imaging with both parameters concordantly. Symmetric bilateral abnormalities were found in four of the 21 patients with NAA/Cho+Cr and in only one of the 21 patients with NAA. With both parameters, no contradictory lateralization was found; however, this was indeed the case with the remaining ratios, NAH/Cr, Cho/Cr, and NAA/Cho, in two, three, and one of the patients, respectively. A statistically significant decrease in NAA was found on the epileptic side, but also on the contralateral side. CONCLUSION: With an adequate asymmetry index, NAA/Cho+Cr and NAA are equally sensitive in predicting the side of involvement in patients with unilateral temporal lobe epilepsy.},
  author       = {Achten, Eric and Boon, Paul and Van de Kerckhove, Tom and Caemaert, Jacques and De Reuck, Jacques and Kunnen, Marc},
  issn         = {0195-6108},
  journal      = {AMERICAN JOURNAL OF NEURORADIOLOGY},
  keyword      = {spectroscopy,magnetic resonance,seizures,MAGNETIC-RESONANCE SPECTROSCOPY,PRESURGICAL EVALUATION,H-1-NMR SPECTROSCOPY,EXTRACTS,ORIGIN,INVIVO},
  language     = {eng},
  number       = {6},
  pages        = {1131--1139},
  title        = {Value of single-voxel proton MR spectroscopy in temporal lobe epilepsy},
  url          = {http://www.ajnr.org/cgi/content/abstract/18/6/1131},
  volume       = {18},
  year         = {1997},
}

Chicago
Achten, Eric, Paul Boon, Tom Van de Kerckhove, Jacques Caemaert, Jacques De Reuck, and Marc Kunnen. 1997. “Value of Single-voxel Proton MR Spectroscopy in Temporal Lobe Epilepsy.” American Journal of Neuroradiology 18 (6): 1131–1139.
APA
Achten, E., Boon, P., Van de Kerckhove, T., Caemaert, J., De Reuck, J., & Kunnen, M. (1997). Value of single-voxel proton MR spectroscopy in temporal lobe epilepsy. AMERICAN JOURNAL OF NEURORADIOLOGY, 18(6), 1131–1139.
Vancouver
1.
Achten E, Boon P, Van de Kerckhove T, Caemaert J, De Reuck J, Kunnen M. Value of single-voxel proton MR spectroscopy in temporal lobe epilepsy. AMERICAN JOURNAL OF NEURORADIOLOGY. 1997;18(6):1131–9.
MLA
Achten, Eric, Paul Boon, Tom Van de Kerckhove, et al. “Value of Single-voxel Proton MR Spectroscopy in Temporal Lobe Epilepsy.” AMERICAN JOURNAL OF NEURORADIOLOGY 18.6 (1997): 1131–1139. Print.