MRI影像改变对颞叶癫痫术后疗效的影响

目的 研究颞叶癫痫(TLE)患者的MRI影像与病理结果 的相关性,分析不同MRI改变对术后疗效的影响.方法 回顾2005年1月至2008年12月在我科手术治疗且有效随访的121例TLE患者的临床资料,统计分析MRI影像改变与病理结果 的关系;根据MRI影像改变将患者分为内侧型TLE、有结构性改变的TLE和隐源性TLE,利用Engel分级将患者分为无发作组和发作组,比较不同类型TLE患者术后疗效的差异.结果 121例患者中MRI结果 阳性101例,病理结果 阳性107例,二者差异无统计学意义,具有良好的相关性.隐源性TLE患者的术后疗效较内侧型TLE和有结构性病变的TLE差,而后二者之间差异无统计学意义.结论 MRI检查对于TLE的确诊及预后判断具有重要意义.

Impact of MRI changes on seizure outcome in patients of temporal lobe epilepsy

Objective In the present study, the correlation of MRI features and pathological changes was studied and the impact of MRI changes on seizure outcome was analyzed. Methods Between Jan. 2005 and Dec. 2008, clinical data of 121 temporal lobe epilepsy (TLE) patients were collected in our institute. Correlation of MRI features and pathological changes was analyzed statistically. According to MRI features, three subtypes of TLEs including medial (MTLE), lesion - related (LTLE) and paradoxical temporal lobe epilepsy (PTLE) were diagnosed. Postoperatively, patients were divided into seizure - free and non - seizure - free group according to Engel seizure classification. Differences of seizure outcome from surgery among different TLE subgroups were compared. Results Among the 121 TLE patients, 101 showed positive MRI findings and 107 showed positive pathological changes. No difference existed. There was a positive correlation between MRI findings and pathological changes. Seizure outcome of PTLE patients was much poorer than that of MTLE and LTLE patients, while no difference existed between the latter two subtypes. Conclusions MRI was one of the most important examinations for the diagnosis of TLE and plays a major role in predicting seizure outcome from surgery among TLE patients.