颞叶癫痫的磁共振波谱学定侧研究

目的　探讨磁共振波谱学 (magneticResonanceSpectroscopy ,MRS)在颞叶癫痫术前定位中的作用。方法　取 18例接受手术治疗的顽固性颞叶癫痫患者为研究对象 ,其术前已接受EEG、MRI和PET等检查获得定位。接受双侧颞叶内侧的MRS检查 ,测定其N -乙酰天门冬氨酸 (NAA)、肌酐 (Cr)和胆碱 (Cho)含量 ,并计算NAA/(Cr Cho)的比值 ;以NAA/(Cr Cho) <0 .6 8和双侧NAA/(Cr Cho)比值的差别 >7%为标准。结果　在18例病例中 16例患侧颞叶MRS检查结果异常 ,其中 9例为患侧MRS异常 ,7例为双侧MRS异常 ,以患侧为重 ,2例患者的比值正常 ;MRS的敏感性高于MR(15 /18) ,与MR结合 ,可对 17例患者进行术前定侧。结论　MRS对颞叶癫痫的定侧诊断有较高的准确性 ,为颞叶癫痫的定位诊断提供新的手段 ;与MRI、PET等手段结合使用 ,可进一步提高对颞叶癫痫诊断的敏感性和准确性

The study of magnetic resonance spectroscopy in the lateralization of temporal lobe epilepsy.

Objective To evaluate the value of MRS in the preoperative lateralization of temporal lobe epilepsy.Methods 18 patients with intractable temporal lobe epilepsy who had been verified by the examintion of EEG,MRI,PET underwent MRS examination for the mediao region of both temopral lobes.The values of NAA,Cr and Cho were calculated by integration of their peaks and the ratios of NAA/(Cr Cho)was measured.We adopted the NAA/(Cr Cho)<0.68 and 7% of the difference of NAA/(Cr Cho) of the two sides as the standards for lateralization.Result A decreassed in the ratio of NAA/(Cr Cho)was found in 16 patients,9 patients had ipsilateral decrease;7 patients had ratio decrease in the epileptic lobe ,also had the less decrease on the contra temporal lobe.Combination of MRS and MR,17 patients could be correctly lateralized before operation.Conclusion As a new method,MRS provides useful information in the preoperative investigation of patients with temporal lobe epilepsy;combined with EEG,MR or PET,MRS may help lateralize the foci in temporal lobe epilepsy.