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Disease Markers
Volume 2016, Article ID 5923243, 9 pages
Research Article

Comparative Lateralizing Ability of Multimodality MRI in Temporal Lobe Epilepsy

1Radiology Department, Ataturk Training Research Hospital, Ankara, Turkey
2Radiology Department, Ondokuz Mayıs University, Samsun, Turkey
3Neurology Department, Gazi University, Ankara, Turkey
4Radiology Department, Johns Hopkins Medical Institution, Baltimore, MD, USA

Received 4 July 2016; Revised 27 September 2016; Accepted 20 October 2016

Academic Editor: Hubertus Himmerich

Copyright © 2016 Karabekir Ercan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. The objective is to compare lateralizing ability of three quantitative MR (qMRI) modalities to depict changes of hippocampal architecture with clinical entities in temporal lobe epilepsy. Methods. We evaluated 14 patients with clinical and EEG proven diagnosis of unilateral TLE and 15 healthy volunteers. T1-weighted 3D dataset for volumetry, single-voxel 1H MR spectroscopy (MRS), and diffusion tensor imaging (DTI) were performed for bilateral hippocampi of all subjects. Results. Individual volumetric measurements provided accurate lateralization in 85% of the patients, spectroscopy in 57%, and DTI in 57%. Higher lateralization ratios were acquired combining volumetry-spectroscopy (85%), spectroscopy-DTI (85%), and volumetry-DTI (100%). Significantly decreased NAA/(Cho+Cr) ratios () and increased FA () values were obtained in ipsilateral to epileptogenic hippocampus. Duration of epilepsy and FA values showed a significant negative correlation (, ). The history of febrile convulsion associated with ipsilateral increased ADC values (, ) and reduced NAA/(Cho+Cr) ratios (, ). Conclusion. Volumetry, MRS, and DTI studies provide complementary information of hippocampal pathology. For lateralization of epileptogenic focus and preoperative examination, volumetry-DTI combination may be indicative of diagnostic accuracy.