MRI and 1H-MRS detects volumetric and metabolic abnormalities of hippocampal sclerosis in temporal lobe epilepsy

Abstract Objective To further investigate the ability of MRI and 1 H-MRS techniques for presurgical evaluation of hippocampal sclerosis. Methods MRI and 1 H-MRS were performed on 30 healthy subjects to determine the confidence levels. Eight patients who were pathologically confirmed hippocampal sclerosis were then studied using the same protocols. The difference of hippocampal formation (DHF) was used to determine atrophy of hippocampus. Areas under the peak of N-acetylaspartate(NAA), Creatine(Cr) and Choline (Cho) were measured, and the ratios of NAA/Cr, Cho/Cr, and NAA/Cr+Cho were calculated. NAA/Cr+Cho value was applied to localize the seizure focus. Results Two patients showed hippocampal atrophy according to DHF value. NAA/Cr ratio decreased significantly in ipsilateral hippocampus compared to that in contralateral hippocampus and control subjects( P P P Conclusion 1 H-MRS should be a promising diagnostic tool to detect neuron abnormality. 1 H-MRS and MRI complement each other in presurgical lateralization of epileptogenic lesion in epilepsy patients.