Abstract

Usefulness of Pulsed Arterial Spin Labeling Magnetic Resonance Imaging in New-onset Seizure Patients and Its Comparison with Dynamic Susceptibility Contrast Magnetic Resonance Imaging.

Bansal, Varun Kumar, Suresh Sharma, Sudhir Sharma, Sanjiv Sood, R. G.

Abstract


Introduction:: Dynamic susceptibility contrast (DSC) perfusion and pulsed arterial spin labeling (PASL) imaging are newer advanced magnetic resonance sequences which are capable of detecting vascular changes in patients with new-onset seizure disorder even when no significant abnormalities are visualized on conventional sequences. The purpose of our study is to establish utility of arterial spin labeling (ASL) in new-onset seizure patients and compare ASL with DSC perfusion sequence. Materials and Methods:: Twenty-six patients coming to emergency department with new-onset seizure disorder were evaluated using DSC and ASL sequence. Perfusion asymmetry was assessed using region of interests taken at places where signal asymmetry was maximal. Results:: PASL sequence showed focal vascular changes in form of hyperperfusion in four patients, hypoperfusion in nine patients, and normal perfusion in 13 patients. Altered perfusion whether hypo/hyperperfusion was detected in five out of 16 patients even when conventional sequences were normal. There was strong positive linear correlation between ASL and DSC with P = 0.001. Conclusion:: Noninvasive PASL is capable of detecting vascular changes induced by seizure and is comparable to DSC sequence. Thus, it is recommended when there is a need for repeated evaluations; in follow-up/therapy response assessment and when contrast administration is contraindicated.


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