Multi-mode Study Of Temporal Lobe Epilepsy By Combining PWI And Resting-state FMRI

ObjectiveThis study combined dynamic susceptibility contrast-enhanced perfusion imaging,arterial spin labeling and resting-state functional magnetic resonance imaging toinvestigate the interictal temporal lobe epilepsy (TLE) perfusion changes in themedial temporal lobe and brain activity changes in resting-state.Materials and MethodsFitfeen right-handed cases of interictal TLE proved by operation and pathologyand Fitfeen matched healthy controls, while the DSC data, ASL data and theResting-state BOLD-fMRI data were recorded by a Siemens3.0T Trio Tim MRscanner. Siemens3.0T Trio Tim MR workstation was used to reconstruct relativecerebral blood volume (rCBV) map and relative cerebral blood flow (rCBF) map,combined with high-resolution anatomical images, the bilateral medial temporal lobewere selected as the region of interest (ROI). Calculation of the bilateral medialtemporal lobe in the case group and control group rCBV, rCBF，a perfusionasymmetry index(AI)was calculated for rCBV, rCBF. The ASL data waspre-processed through sotfware Matlab7.8and SPM8to acquire and compare therCBF maps between the case group and control group. The Resting-state BOLD-fMRIdata was pre-processed through software Matlab7.8, SPM8, DPARSF and RESTsotfware package to acquire regional homogeneity maps in whole brain, compare theregional homogeneity maps of two groups to acquire difference maps. To measure theReHo value of ROI in bilateral medial temporal lobe, then compare the ReHo valuesin case group and control group.Results1. There were no statistically significant differences in rCBV, rCBF between thebilateral mesial temporal lobe in the controls. TLE patients ipsilateral medial temporallobe rCBV,rCBF were lower than the contralateral(P<0.05)； the TLE groups AlrCBV,AlrCBF were significantly higher than the control group P<0.05). 2.AlrCBV, AlrCBF change in medial temporal lobe was significantly positivecorrelated with the course of disease inTLE group.3.Comparedwith controls, TLE patients showed significantly decreased ReHovalue in right cerebellum posterior lobe, letf inferior temporal gyrus, letf middletemporal gyrus, letf hippocampus, corpus callosum, thalamus and right precuneus, letfinferior parietal lobule, letf middle frontal gyrus and medial frontal gyrus, andsignificantly increased ReHo value mainly in brainstem, right precentral, anteriorcingulate, letf parahippocampal gyrus, letf superior temporal gyrus and rightparahippocampal gyrus. There were no statistically significant differences in ReHovalue between the bilateral mesial temporal lobe in the controls (P>0.05), TLEpatients ipsilateral medial temporal lobe ReHo value were lower than the contralateral(P <0.05).Conclusion1.In interictal TLE patients，ipsilateral medial lobe rCBV,rCBF decreased.2.In the resting state， There are abnormal brain function networks widelyexist in the TLE patients.3.ReHo can detect the abnormal regional homogeneity of the BOLD signalscaused by epilepsy, and may be helpful to explore the pathophysiological mechanismof epilepsy.