Interictal arterial spin-labeling MRI perfusion in intractable epilepsy

Arterial Spin Labeling Perfusion of the Brain: Emerging Clinical Applications

“…Since standard structural MR imaging is routinely performed, ASL might be of interest as an additional functional marker of cerebral perfusion with minimal additional effort. Hypoperfusion on ASL corresponds to hypoperfusion on interictal PET and electrophysiological data (75,76,80), indicating the potential use of ASL for epileptic focus localization ( Figure 8). …”

“…ASL might further be helpful in the differential diagnosis for example in assessing for a stroke in the acute stage. During the acute peri-ictal period, the CBF is typically increased due to pathologic neuronal activity (74), while in the chronic inter-ictal period, CBF is typically reduced as the epileptogenic region typically is less functional and active as compared to the normal brain tissue (75)(76)(77)(78)(79).…”

Ictal focal hyperperfusion demonstrated by arterial spin-labeling perfusion MRI in partial epilepsy status

“…Diffusion-weighted imaging (DWI) (c) shows hyperintense signals in the focal cortical area (white arrows) corresponding to the abnormal cortex on STIR. Pulsed arterial spin-labeling imaging (d) demonstrates strong cortical hyperperfusion in the medial to lateral occipital cortices, much more widely distributed than the abnormal signal alteration on DWI Some authors have investigated the utility of focal interictal perfusion abnormalities shown by PASL as a marker for localizing the epileptic focus in partial epilepsy [2][3][4]. They observed significant correlations between the interictal hypoperfusion demonstrated by PASL and the results of positron emission tomography or SPECT imaging in the ictal period.…”

Arterial spin-labeling magnetic resonance imaging for diagnosis of early seizure after stroke

“…ASL is a Journal of the Neurological Sciences 354 (2015) 127-128 non-invasive imaging sequence of MRI to evaluate cerebral perfusion without requiring administration of contrast agent [7]. ASL imaging can detect the cortical hyperperfusion that occurs in the peri-ictal phase of the seizure [8][9][10]. Although ASL has recently been reported as useful in the differentiation of late seizure from recurrent stroke [2], its usefulness in early seizure has not previously been described.…”