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Summary: Purpose: To assess the magnetic resonance imaging (MRI), positron emission tomography (PET), pathology, and clinical findings of patients with the MRI feature of white-matter change (WMC) in the anterior temporal lobe. Methods: Fifty-six patients with pathologically proven mesial temporal sclerosis were included in this study. MRI and 18F-2-deoxyglucose-(FDG) PET images were obtained before surgery in all patients. The patients were divided into two groups according to the presence of WMC on their MRI. WMC consists of an indistinct gray-white matter demarcation and an increased signal intensity of the anterior temporal lobe on T2-weighted images. The two groups were then compared in terms of MRI, PET, pathology, and clinical features. Results: The MRI feature of WMC was observed in 18 (32%) of the 56 patients. PET images of those patients revealed more severe hypometabolism of the ipsilateral temporal lobes (p > 0.05). In terms of histologic findings, larger numbers of het-erotopic neurons were observed in the anterior temporal lobe white matter of these patients who also shared the following clinical features: earlier seizure onset, frequent history of febrile convulsions, and favorable surgical outcomes. Conclusions: The MRI feature of WMC is an additive sign for correct seizure lateralization and may be related to a favorable surgical outcome in patients with temporal lobe epilepsy.

Purpose: To evaluate the usefulness of functional MR imaging (fMRI) for the determination of languagedomi-nance and to assess differences in language lateralization according to activation task or activated area.Materials and Methods: Functional maps of the language area were obtained during word generation tasks (noun andverb) and a reading task in ten patients (9 right handed, 1 left handed) who had undergone the Wada test. MRexaminations were performed using a 1.5T scanner and the EPI BOLD technique. The SPM program was employed for thepostprocessing of images and the threshold for significance was set at p