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This study investigated the diagnostic value of proton magnetic resonance spectroscopy (MRS) findings in temporal lobe epilepsy (TLE). 24 patients whose neurologic examinations revealed TLE were examined by EEG, magnetic resonance imaging (MRI) and MRS and ten healthy volunteers by MRI and MRS. In the patient group, EEG abnormalities were seen in 15 cases, MRI abnormalities in 12 and MRS abnormalities in 17. In 14 patients, MRS lateralized the seizure focus. MRS is an effective modality for demonstrating temporal lobe abnormalities and contributes to lateralization of the epileptic focus.

Fluid-attenuated inversion recovery (FLAIR) imaging with contrast enhancement is highly sensitive for detecting subarachnoid space disease. We hypothesized that contrast-enhanced FLAIR imaging with magnetization transfer would offer superior sensitivity to contrast-enhanced T1-weighted MR imaging with magnetization transfer in detecting TB meningitis. Forty-four patients referred for suspected TB meningitis underwent MR imaging studies. The patients had either proven TB meningitis or negative TB meningitis. The MR imaging examinations included both contrast-enhanced FLAIR and T1-weighted MR images with magnetization transfers that were independently reviewed by two neuroradiologists. Each of the sequences was reviewed individually and separately and was assigned a score of positive or negative for TB meningitis. Of the 21 studies of patients with proven TB meningitis, nine were positive based on contrast-enhanced FLAIR images with magnetization transfer, and 13 were positive based on contrast-enhanced T1-weighted MR images with magnetization transfer. Of the 23 studies of patients without TB meningitis, 19 were negative based on contrast-enhanced FLAIR images, and 20 were negative based on contrast-enhanced T1-weighted MR images with magnetization transfer. The sensitivity and specificity for contrast-enhanced FLAIR images for detecting TB meningitis were 43% (nine of 21) and 82% (19 of 23), respectively. The sensitivity and specificity of contrast-enhanced T1-weighted MR images with magnetization transfer for detecting TB meningitis were 62% (13 of 21) and 87% (20 of 23), respectively. Contrast-enhanced FLAIR imaging with magnetization transfer is less sensitive than contrast-enhanced T1-weighted MR sequences with magnetization transfer in detecting TB meningitis.