Peranan T1-Weighted Post-Contrast dan Dynamic Susceptibility Contrast (DSC) Perfusion pada Pemeriksaan MRI Brain Pasien dengan Indikasi Klinis Epilepsi di Rumah Sakit Umum Pusat Surabaya

Authors

  • Putu Amanda Prasaka Putri AKTEK Radiodiagnostik dan Radioterapi Bali
  • Ni Putu Rita Jeniyanthi AKTEK Radiodiagnostik dan Radioterapi Bali
  • Nur Salsabila Sandy Rumah Sakit Umum Pusat Surabaya

DOI:

https://doi.org/10.31004/koloni.v5i3.1402

Keywords:

epilepsy, brain MRI, T1-weighted post-contrast, DSC perfusion, hippocampus

Abstract

Epilepsy is a neurological disorder characterized by recurrent seizures caused by abnormal electrical activity in the brain and may be associated with structural or functional abnormalities. Magnetic resonance imaging (MRI) plays an important role in identifying the underlying causes of epilepsy and determining the need for additional imaging techniques. This study aimed to describe the role of T1-weighted post-contrast and Dynamic Susceptibility Contrast (DSC) perfusion in brain MRI examinations of patients with clinical indications of epilepsy at RSUP Surabaya. This study used a qualitative descriptive method with a multiple case study design involving three patients who underwent brain MRI examinations using a 1.5 Tesla Philips MRI scanner. Data were collected through image observation, examination documentation, radiology reports, and interviews with two radiographers and one radiologist. The results showed that T1-weighted post-contrast contributed to the evaluation of enhancement characteristics, particularly in a patient with a right temporal mass showing strong enhancement. In suspected mesial temporal sclerosis, the main findings were obtained from structural sequences, showing bilateral hippocampal FLAIR hyperintensity with right hippocampal atrophy without abnormal enhancement. DSC perfusion provided additional information regarding tissue perfusion, showing perfusion differences between the lesion and contralateral tissue in the mass case. This study concludes that T1-weighted post-contrast and DSC perfusion have complementary roles and can be selectively applied according to MRI findings and clinical needs in epilepsy patients.

References

Abdelrazek, G. M., Bakri, A. H., & Melad, O. (2024). Role of Diffusion-Weighted and Contrast Enhanced MRI Brain in the Evaluation of Paediatric Epilepsy. SVU-International Journal of Medical Sciences, 7(1), 809–818. https://doi.org/10.21608/svuijm.2022.158921.1397

Aklamanu, B. W. (2025). A review of neuroimaging in epilepsy: Diagnostic strategies and clinical decision framework. Brain Disorders, 19(July), 100261. https://doi.org/10.1016/j.dscb.2025.100261

Andrijauskis, D., Woolf, G., Kuehne, A., Al-Dasuqi, K., Silva, C. T., Payabvash, S., & Malhotra, A. (2023). Utility of Gadolinium-Based Contrast in Initial Evaluation of Seizures in Children Presenting Emergently. American Journal of Neuroradiology, 44(10), 1208–1211. https://doi.org/10.3174/ajnr.A7976

Aprilia, H. P., Jeniyanthi, N. P. R., & Supriyani, N. (2024). Analisis Pemeriksaan Magnetic Resonance Imaging (Mri) Brain Dengan Klinis Epilepsi Di Rumah Sakit Umum Pusat Dr Hasan Sadikin Bandung. Prepotif : Jurnal Kesehatan Masyarakat, 8(3), 7917–7926. https://doi.org/10.31004/prepotif.v8i3.35091

Bansal, V., Kumar, S., Sharma, S., Sharma, S., & Sood, R. (2017). Usefulness of pulsed arterial spin labeling magnetic resonance imaging in new-onset seizure patients and its comparison with dynamic susceptibility contrast magnetic resonance imaging. Journal of Neurosciences in Rural Practice, 8(4), 569–574. https://doi.org/10.4103/jnrp.jnrp_141_17

Bernasconi, A., Cendes, F., Theodore, W. H., Gill, R. S., Koepp, M. J., Hogan, R. E., … Bernasconi, N. (2019). Recommendations for the use of structural magnetic resonance imaging in the care of patients with epilepsy: A consensus report from the International League Against Epilepsy Neuroimaging Task Force. Epilepsia, 60(6), 1054–1068. https://doi.org/10.1111/epi.15612

Cendes, F. (2013). Neuroimaging in investigation of patients with epilepsy. CONTINUUM Lifelong Learning in Neurology, 19(3), 623–642. https://doi.org/10.1212/01.CON.0000431379.29065.d3

Cendes, F., Theodore, W. H., Brinkmann, B. H., Sulc, V., & Cascino, G. D. (2016). Neuroimaging of epilepsy. In Handb Clin Neurol (Vol. 28). https://doi.org/10.1016/B978-0-444-53486-6.00051-X

Chen, C., Xie, J. J., Ding, F., Jiang, Y. S., Jin, B., Wang, S., … Wang, S. (2021). 7T MRI with post-processing for the presurgical evaluation of pharmacoresistant focal epilepsy. Therapeutic Advances in Neurological Disorders, 14, 1–14. https://doi.org/10.1177/17562864211021181

Filipovic, T., Popovic, K. S., Ihan, A., & Vodusek, D. B. (2017). Dynamic susceptibility contrast enhanced (DSC) MRI perfusion and plasma cytokine levels in patients after tonic-clonic seizures. Radiology and Oncology, 51(3), 277–285. https://doi.org/10.1515/raon-2017-0031

Fussell, D., & Young, R. J. (2013). Role of MRI perfusion in improving the treatment of brain tumors. Imaging in Medicine, 5(5), 407–426. https://doi.org/10.2217/iim.13.50

Hanisa, Juliantara, I. P. E., & Widodo, R. (2023). Prosedur Pemeriksaan Magnetic Resonance Imaging (MRI) Brain Pada Kasus Epilepsi. Jurnal Ilmu Kedokteran Dan Kesehatan Malahayati, 10(10), 2916–2923.

Kim, N. Y., Baek, H. J., Choi, D. S., Ha, J. Y., Shin, H. S., Kim, J. H., … Park, M. J. (2017). MR Findings of Seizure-Related Cerebral Cortical Lesions during Periictal Period. Investigative Magnetic Resonance Imaging, 21(2), 82. https://doi.org/10.13104/imri.2017.21.2.82

Kim, T. J., Choi, J. W., Han, M., Kim, B. G., Park, S. A., Huh, K., & Choi, J. Y. (2021). Usefulness of arterial spin labeling perfusion as an initial evaluation of status epilepticus. Scientific Reports, 11(1), 1–11. https://doi.org/10.1038/s41598-021-03698-7

Panie, R. M. L., Wulandari, P. I., Triningsih, & Anak Agung Ayu Meidiary. (2024). Peranan Sekuen T1 SPACE Coronal Pada Pemeriksaan MRI Brain Dengan Klinis Epilepsi Lobus Temporal Di Unit Radiologi RSUP Prof. Dr. I.G.N.G. Ngoerah Denpasar. Jurnal Ilmu Kesehatan Dan Gizi, 2(1), 53–58. Retrieved from https://doi.org/10.55606/jikg.v2i1.2099

Ponnatapura, J., Vemanna, S., Ballal, S., & Singla, A. (2018). Utility of Magnetic Resonance Imaging Brain Epilepsy Protocol in New-Onset Seizures: How is it Different in Developing Countries? Journal of Clinical Imaging Science, 8, 43. https://doi.org/10.4103/jcis.jcis_38_18

Silfina, R. O., Indrati, R., & Utami, L. R. W. (2021). The role T1-weighted fluid attenuated inversion recovery (FLAIR) post contrast enhancement to improve image quality on MRI brain. Journal of Physics: Conference Series, 1943(1). https://doi.org/10.1088/1742-6596/1943/1/012052

Sinha, N. K., Raj, G., Ghosh, R. P., & Srivastava, S. (2026). Mri Protocol for Epilepsy Imaging in the Developing World: a Practical Proposal. International Journal of Medicine and Public Health, 16(2), 591–594. https://doi.org/10.70034/ijmedph.2026.2.99

van der Weijden, C. W. J., Gutmann, I. W., Somsen, J. F., Luurtsema, G., van der Goot, T., Arzanforoosh, F., … van der Hoorn, A. (2025). DSC Perfusion MRI Artefact Reduction Strategies: A Short Overview for Clinicians and Scientific Applications. Journal of Clinical Medicine, 14(13), 1–19. https://doi.org/10.3390/JCM14134776

Wang, I., Bernasconi, A., Bernhardt, B., Blumenfeld, H., Cendes, F., Chinvarun, Y., … Federico, P. (2020). MRI essentials in epileptology: a review from the ILAE Imaging Taskforce. Epileptic Disorders, 22(4), 421–437. https://doi.org/10.1684/epd.2020.1174

Westbrook, C. (2014). Handbook Of MRI Technique. In Library of Congress Cataloging-in-Publication Data (Fourth Edi, Vol. 8). Wiley Blackwell.

Willa, D. C., Lana Prasetya, I. M., & Sari Widari, N. L. P. (2025). Analisis Kualitas Citra MRI Brain pada Sekuen TI Space (Studi Komperasigrappa) pada Kasus Epilepsi Potongan Coronal di Unit Radiologi RSUP Prof. Dr. I.G.N.G. Ngoerah Denpasar. Jurnal Surya Medika, 11(2), 185–189. https://doi.org/10.33084/jsm.v11i2.7713

Xing, W., Wang, X., Xie, F., & Liao, W. (2013). Application of dynamic susceptibility contrast-enhanced perfusion in temporal lobe epilepsy. Acta Radiologica, 54(1), 107–112. https://doi.org/10.1258/ar.2012.110658

Downloads

Published

30-09-2026

How to Cite

Putri, P. A. P., Jeniyanthi, N. P. R., & Sandy, N. S. (2026). Peranan T1-Weighted Post-Contrast dan Dynamic Susceptibility Contrast (DSC) Perfusion pada Pemeriksaan MRI Brain Pasien dengan Indikasi Klinis Epilepsi di Rumah Sakit Umum Pusat Surabaya. KOLONI, 5(3), 4443–4456. https://doi.org/10.31004/koloni.v5i3.1402