N-acetylaspartate and myo-inositol provide complementary information for lateralization of mesial temporal lobe epilepsy

Lateralization of drug refractory mesial temporal lobe epilepsy can be challenging for routine MR scans at 3.0T. Exogenous and radioactive tracer 18F-FDG has been widely reported to aid the lateralization of MR unidentifiable epileptic hippocampus. 1H-MRSI holds promise to provide endogenous metabolic information of the epileptogenic zone. This study demonstrated the feasibility of fast high-resolution mapping of NAA/Cr, mIn/Cr and mIn/NAA, and investigated their associations with the FDG uptake. Our experimental results showed that NAA and mIn were independently sensitive to metabolic changes in hippocampal sclerosis, providing complementary information for temporal lobe epilepsy lateralization.