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Fig. 4 | Egyptian Journal of Radiology and Nuclear Medicine

Fig. 4

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

Fig. 4

A 33-year-old female patient, with focal impaired awareness seizures. The structural MR images: including axial T2WI (a), axial FLAIR image (b) and axial 3D T1WI (c), as well as axial DWI (d), all are unremarkable and negative. The MV 1H-MRS picture maps are demonstrated, 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 0.59 and 1.1, respectively (e) in comparison with the contralateral non-epileptic left temporal lobe measuring about 1 and 2.1, respectively (f). The FA map (g) revealed focal decrease in the FA value in the right temporal lobe (white arrow) measuring 0.18, while MD map (h) reveals focal increase in the MD value in the right temporal lobe measuring 8.6 × 10–3 m2/sec (white arrow). The ASL-MRI color-coded cerebral perfusion map (i) reveals scattered foci of hypoperfusion of the right temporal lobe with rCBF measuring about 72 ml/100 g/min (white arrow). The clinical examinations and EEG studies confirmed our results

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