ABSTRACT
Background:
Recent our
reports showed that 3-T pseudocontinuous arterial spin labeling (3-T pCASL)
magnetic resonance perfusion imaging with dual post labeling delay (PLD) of 1.5 and 2.5 s clearly demonstrated the
hemodynamics of ictal hyperperfusion associated with
non-convulsive status epilepticus (NCSE). We aimed to examine the utility of 1.5-T pulsed arterial spin labeling (1.5-T PASL), which is more widely available for daily clinical use, for detecting ictal hyperperfusion.
Methods:
We retrospectively analyzed the findings of 1.5-T PASL with dual PLD of 1.5 s and 2.0 s in six
patients and compared the findings with ictal electroencephalographic (
EEG) findings.
Results:
In
patients 1 and 2, we observed the repeated occurrence of ictal discharges (RID) on
EEG. In
patient 1, with PLDs of 1.5 s and 2.0 s, ictal ASL hyperperfusion was observed at the site that matched the RID
localization. In
patient 2, the RID amplitude was extremely low, with no ictal ASL hyperperfusion. In
patient 3 with lateralized periodic discharges (LPD), we observed ictal ASL hyperperfusion at the site of maximal LPD amplitude, which was apparent at a PLD of 2.0 s but not 1.5 sec. Among three
patients with rhythmic
delta activity (RDA) of frequencies <2.5 Hz (
Patients 4-6), we observed obvious and slight increases in ASL signals in
patients 4 and 5 with NCSE, respectively. However, there was no apparent change in ASL signals in
patient 6 with possible NCSE.
Conclusion:
The
detection of ictal hyperperfusion on 1.5-T PASL might depend on the electrophysiological intensity of the epileptic ictus, which seemed to be more prominent on 1.5-T PASL than on 3-T pCASL. The 1.5-T PASL with dual PLDs showed the
hemodynamics of ictal hyperperfusion in
patients with RID and LPD. However, it may not be visualized in
patients with extremely low amplitude RID or RDA (frequencies <2.5 Hz).
