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Fig. 2 | Egyptian Journal of Radiology and Nuclear Medicine

Fig. 2

From: Arterial spin-labelling and magnetic resonance spectroscopy as imaging biomarkers for detection of epileptogenic zone in non-lesional focal impaired awareness epilepsy

Fig. 2

ai A 33-year-old female patient of non-lesional left frontal lobe FIAE The visual-based analysis of the axial PASL-MRI colour-coded cerebral perfusion map (a) demonstrates a focal hypoperfusion of the left frontal lobe (white arrows) and ipsilateral thalamus (yellow arrows). The estimated rCBF for right and left frontal lobes was 76.25 and 62.67 ml/100 g/min, respectively, with the calculated ASLAI% of 14.91%. Additionally, the estimated rCBF of the right and left thalami was 74.77 and 69.09 ml/100 g/min, respectively, with the calculated ASLAI% of 8.90%. The MV 1H-MRS picture maps of both frontal lobes and thalami, were obtained at a long TE of 144 ms (b and f, respectively) and at a short TE of 35 ms (c and g, respectively). The MRS spectra demonstrate increased MI/NAA, Glx/NAA and Glx/Cr, as well as decreased NAA/(Cho + Cr) ratios in the left frontal lobe (e) compared to the right frontal lobe (d), while the ipsilateral left thalamus (i), when compared to the contra-lateral right thalamus (h), showed decreased MI/NAA and NAA/(Cho + Cr), as well as increased Glx/NAA and Glx/Cr ratios. For right and left frontal lobes, these ratios were [NAA/(Cho + Cr) = 0.80 and 0.55 with %AF of 38.24%, MI/NAA = 0.20 and 1.27 with %AF of 14.56%, Glx/NAA = 1.33 and 1.58 with %AF of 17.18% and Glx/Cr = 1.30 and 1.53 with %AF of 16.25%]. These ratios for right and left thalami, respectively, are [NAA/(Cho + Cr) = 0.60 and 0.46 with %AF of 26.42%, MI/NAA = 0.38 and 0.27 with %AF of 33.85%, Glx/ NAA = 1.28 and 1.49 with %AF of 15.16% and Glx/Cr = 1.25 and 1.45, with %AF of 14.81%]

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