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Egyptian Journal of Radiology and Nuclear Medicine
Fig. 3 | Egyptian Journal of Radiology and Nuclear Medicine

Fig. 3

From: Usefulness of combined diffusion tensor imaging, arterial spin labelling and spectroscopic interictal analysis in refractory epilepsy

Fig. 3

A 17-year-old male patient presented with focal dyscognitive seizures. The structural MR images, including axial T2WI (a), axial FLAIR image (b) axial DWI (c) and ADC at b value 0 s/mm2 (d) as well as coronal T2 IR and axial 3D T1WI (e) and (f), respectively), all are unremarkable and negative. The MV 1H-MRS picture maps are demonstrated in (g). The MRS spectra of the right and left temporal lobes reflect the decrease in NAA/(Cho + Cr) and (NAA/Cr) ratios in the zone of epileptogenic activity in the right temporal lobe measuring about 0.6 and 0.8, respectively (h) in comparison with the contralateral non-epileptic left temporal lobe measuring about 1.3 and 3.8, respectively (i). The FA map (j) revealed focal decrease in the FA value in the right temporal lobe measuring 0.20 (white arrow), while MD map (k) revealed focal increase in the MD value in the right temporal lobe 8.4 × 10–3 m2/sec (white arrow). The ASL-MRI color-coded cerebral perfusion map (f) reveals no perfusion abnormalities. The clinical examinations and EEG studies confirmed our results. (l) Enumeration letter of pictures in the case presentation

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