Cerebral perfusion alterations in epileptic patients during peri-ictal and post-ictal phase: PASL vs DSC-MRI

Non-invasive pulsed arterial spin labeling (PASL) MRI is a method to study brain perfusion that does not require the administration of a contrast agent, which makes it a valuable diagnostic tool as it reduces cost and side effects. The purpose of the present study was to establish the viability of P...

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Bibliographic Details
Published in:Magnetic resonance imaging Vol. 31; no. 6; pp. 1001 - 1005
Main Authors: Pizzini, Francesca B., Farace, Paolo, Manganotti, Paolo, Zoccatelli, Giada, Bongiovanni, Luigi G., Golay, Xavier, Beltramello, Alberto, Osculati, Antonio, Bertini, Giuseppe, Fabene, Paolo F.
Format: Journal Article
Language:English
Published: Netherlands Elsevier Inc 01.07.2013
Subjects:
Adult
Arterial spin labeling
Asymmetry
Blood Flow Velocity
Brain Mapping - methods
Cerebrovascular Circulation
Epilepsy
Epilepsy - diagnosis
Epilepsy - physiopathology
Female
Humans
Hyperperfusion
Hypoperfusion
Image Enhancement - methods
Image Interpretation, Computer-Assisted - methods
Magnetic Resonance Angiography - methods
Magnetic resonance imaging
Male
Middle Aged
Radiology
Reproducibility of Results
Sensitivity and Specificity
Young Adult
Hypoperfusion
Magnetic resonance imaging
Hyperperfusion
Epilepsy
Arterial spin labeling
ISSN:0730-725X, 1873-5894, 1873-5894
Online Access:Get full text
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Summary:Non-invasive pulsed arterial spin labeling (PASL) MRI is a method to study brain perfusion that does not require the administration of a contrast agent, which makes it a valuable diagnostic tool as it reduces cost and side effects. The purpose of the present study was to establish the viability of PASL as an alternative to dynamic susceptibility contrast (DSC-MRI) and other perfusion imaging methods in characterizing changes in perfusion patterns caused by seizures in epileptic patients. We evaluated 19 patients with PASL. Of these, the 9 affected by high-frequency seizures were observed during the peri-ictal period (within 5hours since the last seizure), while the 10 patients affected by low-frequency seizures were observed in the post-ictal period. For comparison, 17/19 patients were also evaluated with DSC-MRI and CBF/CBV. PASL imaging showed focal vascular changes, which allowed the classification of patients in three categories: 8 patients characterized by increased perfusion, 4 patients with normal perfusion and 7 patients with decreased perfusion. PASL perfusion imaging findings were comparable to those obtained by DSC-MRI. Since PASL is a) sensitive to vascular alterations induced by epileptic seizures, b) comparable to DSC-MRI for detecting perfusion asymmetries, c) potentially capable of detecting time-related perfusion changes, it can be recommended for repeated evaluations, to identify the epileptic focus, and in follow-up and/or therapy-response assessment.
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ISSN:0730-725X
1873-5894
1873-5894
DOI:10.1016/j.mri.2013.03.023