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European Radiology

, Volume 19, Issue 2, pp 400–408 | Cite as

1H MR spectroscopy in histopathological subgroups of mesial temporal lobe epilepsy

  • Milan Hajek
  • Pavel Krsek
  • Monika Dezortova
  • Petr Marusic
  • Josef Zamecnik
  • Martin Kyncl
  • Martin Tomasek
  • Hana Krijtova
  • Vladimir Komarek
Magnetic Resonance

Abstract

The aim of the study was to analyze the lateralizing value of proton magnetic resonance spectroscopy (1H MRS) in histopathologically different subgroups of mesial temporal lobe epilepsies (MTLE) and to correlate results with clinical, MRI and seizure outcome data. A group of 35 patients who underwent resective epilepsy surgery was retrospectively studied. Hippocampal 1H MR spectra were evaluated. Metabolite concentrations were obtained using LCModel and NAA/Cr, NAA/Cho, NAA/(Cr+Cho), Cho/Cr ratios and coefficients of asymmetry were calculated. MRI correctly lateralized 89% of subjects and 1H MRS 83%. MRI together with 1H MRS correctly lateralized 100% of patients. Nineteen subjects had “classical” hippocampal sclerosis (HS), whereas the remaining 16 patients had “mild” HS. Nineteen patients had histopathologically proven malformation of cortical development (MCD) in the temporal pole; 16 subjects had only HS. No difference in 1H MRS findings was found between patients in different histopathological subgroups of MTLE. Our results support the hypothesis that 1H MRS abnormalities do not directly reflect histopathological changes in MTLE patients. Subjects with non-lateralized 1H MRS abnormalities did not have a worse postoperative seizure outcome. We found no significant impact of contralateral 1H MRS abnormality on post-surgical seizure outcome.

Keywords

MR spectroscopy Temporal lobe epilepsy Hippocampus Malformations of cortical development Treatment outcome 

Notes

Acknowledgement

Supported by grants GACR no. 309/02/D076 and IGA no. NR/8843-4 and Research Projects nos. 00000064203 and MZ0IKEM2005.

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Copyright information

© European Society of Radiology 2008

Authors and Affiliations

  • Milan Hajek
    • 1
  • Pavel Krsek
    • 2
  • Monika Dezortova
    • 1
  • Petr Marusic
    • 3
  • Josef Zamecnik
    • 4
  • Martin Kyncl
    • 5
  • Martin Tomasek
    • 3
  • Hana Krijtova
    • 3
  • Vladimir Komarek
    • 2
  1. 1.MR Unit, Department of Diagnostic and Interventional RadiologyInstitute for Clinical and Experimental MedicinePragueCzech Republic
  2. 2.Department of Pediatric NeurologyCharles UniversityPrague 5Czech Republic
  3. 3.Department of NeurologyCharles UniversityPragueCzech Republic
  4. 4.Department of Pathology and Molecular MedicineCharles UniversityPragueCzech Republic
  5. 5.Department of RadiologyCharles UniversityPragueCzech Republic

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