颞叶癫痫的核磁共振质子波谱与术后病理对照研究

目的：通过对症状明确的颞叶癫痫病人术前的核磁共振质子波与术后病理进行对照分析，评价核磁共振质子波谱分析对颞叶癫痫的诊断价值。方法：24例症状明确的颞叶癫痫病人，术前均作发作间期脑电图和／或视频脑电监测及MRI、PET检查。根据临床表现，脑电、MRI、PET等检查结果综合评估确定病侧，术前做双侧近中颞叶脑组织的核磁共振质子波谱，术中在脑电监测下切除病灶及致痫灶并送病理检查。结果：本组24例病人有19例单侧或双侧颞叶的NAA／（CR＋CHO）值低于0．6，其中13例为双侧异常，另外6例为单侧异常；双侧均不低于0．6的有5例，均有一侧至少低于对照0．07，可确定为异常，其中2例MRS检查结果与术后病理结果不相吻合。结论：颞叶癫痫病人的地脑组织核磁共振质子波谱检查异常侧与病理改变有较好的对应性，它可以无创性探测活体脑组织代谢功能的异常，MRS不仅可以发现双侧病变，而且可以指出病理改变较严重的一侧，为术前癫痫灶的定位、定侧提供可靠的依据。

Compared analysis of the preoperational megnetic resonance spectroscopy with postoperationan pathology of patients with temporal lobe epilepsy

Objectively: Compared analysis the results of the preoperational Megnetic Resonance Spectroscopy (MRS) with postoperational pathology of the patients with temproal lobe epilepsy (TLE). Determined the relative utility of the preoperational Magnetic Resonance Spectroscopy for presurgical diagnosis of temproal lobe epilepsy. Methods: Preoperational megnetic resonance spectroscopy and post- operational pathologic examination were performed in 24 patients with temproal lobe epilepsy. The fo- cus were resected with the intraoperative monitoring of EEG and the pathological examination were performed. Compared analysis the results of the MRS and the postoperational pathology. Results: All of the cases (24) have pathological alterations, 16(69.5%)cases express hippicampal sclerosis, 15 cases of 16 have normal expression on MRI. On the basis of the NAA/CR + CHO ratio, all of the cases(24) can be achieved lateralization with tow incorrect, 22 cases which the metablic abnormalities and the patho- logical alterations are in the same side and 2 cases which the sides of abnormanl expression on MRS and pathological analysis are in different sides were found. Conclusion: MRS could provide biochemical and metabolic in formations for the preoperative investigation on patients with temproal lobe epilepsy, cont- ributing to the location of seizure focus and setection of bilateral abnormlities, consisting with the pathologic alterations very well. The MRS is a useful intactable diagnostic technique for preoperational evaluation of patients with temproal lobe epilepsy who are eligible for resective surgery.