质子磁共振波谱对颞叶癫癎的诊断价值

目的:评价磁共振质子波谱(H MRS)对颞叶癫癎的诊断价值.方法:对20例健康人和18例颞叶癫癎病人进行1H MRS采集,并定量分析了癫痫病人的N-乙酰天门冬氨酸(NAA)、肌酸(Cr)和胆碱复合物(Cho)等代谢产物的变化.结果:癫癎病人致癫灶NAA峰以及NAA/(Cho cr)、NAA/Cr和NAA/Cho比值低于病灶对侧,亦低于健康对照组.正常对照组NAA/(Cho Cr)值平均为0.78,双侧差别小于0.07.我们以NAA/(Cho Cr)值＜0.68和双侧NAA/(Cho Cr)比值的差别＞0.07为判断标准,18例颞叶癫癎病人中,16例为单侧MRS异常,2例为双侧异常.结论:质子磁共振波谱能无创性探测脑组织内生化及代谢改变,是诊断颞叶癫癎的有效手段之一.

Diagnostic value of proton magnetic resonance spectroscopy in temporal lobe epilepsy

Objective:To evaluate the diagnostic value of proton magnetic resonamce spectroscopy(1H MRS) in temporal lobe epilepsy(TLE).Methods:1H MRS were performed on the hippocampi of 20 healthy volunteers and 18 patients with unilateral mesial TLE and the signals from N-acetylaspartate(NAA) Creatine+phosphocreating (Cr)and choline-Containing(Cho) were analyzed.Results:The concentration of NAA and the ratio of NAA/(Cho+Cr),NAA/Cr and NAA/Cho in epileptogenic foci were lower than that of the sites on the opposite side and control subjects. The NAA/(Cho+Cr)ratio of the normal control subjects was 0.78.NAA/(Cho+Cr)<0.68 and >0.07 of the difference of NAA/(Cho+Cr) of two sides were considered as the standards for the lateralization diagnosis of TLE,in 18 patients,16 patients had ipsilatral decrease,2 patients showing abnormalities in patients of temporal lobe epilepsy.Conclusion:1H MRS can provide biochemical and metabolic information of human brain. 1H MRS is a useful and effective diagnostic tool in the evaluation of TLE.