Abstract：Objective: To compare the results of the preoperational 1H MRS with PET/CT, electroencephalogram(EEG) and postoperational pathology of the patients with temporal lobe epilepsy(TLE) and to determine the relative utility of the preoperational 1H MRS for the diagnosis and presurgical lateralization of temporal lobe epilepsy. Methods: EEG and PET/CT were performed in all of the 16 patients. 1H MRS was performed in 16 patients with TLE and 28 healthy volunteers. Signals from N-acetylaspartate(NAA), creatine(Cr) and choline-containing compounds(Cho) were observed. The focus of 3 patients was resected with the intraoperative monitoring of EEG and the pathological examination were performed. Results: Analysis demonstrated the difference of NAA/Cr, Cho/Cr and NAA/（Cho+Cr） among the abnormal side, contralateral side and control group had statistical significance (P<0.05). On the basis of NAA/（Cho+Cr） ratio, lateralization was achieved in 14 cases. Bilateral abnormalities were showed in 11 cases with the ipsilateral side more severe than that of contralateral side. Unilateral abnormalities were showed in 5 cases. 1H MRS had a sensitivity of 87% for lateralization of seizure in TLE. Conclusion: 1H MRS could contribute to the location of seizure focus and detection of bilateral abnormalities, consisting with the findings of EEG and PET and pathologic alterations very well. 1H MRS is a useful noninvasive diagnostic technique for preoperational evaluation of patients with TLE who are eligible for surgery.
2006, Vol. 17 
