儿童局灶性颞叶癫痫：3.0T 1H-MRS及MR海马容积分析

目的：探讨3.0T氢质子磁共振波谱(1H-MRS)与磁共振容积测量（vMR）对儿童局灶性颞叶癫痫（fTLE）的诊断价值及临床相关因素分析。材料与方法：对30例经24小时动态脑电图确诊的fTLE患儿（年龄5～14岁，平均8.5岁）行3.0T 1H-MRS分析及vMR测量，并以随机的30名儿童（年龄5～14岁，平均8.8岁）对照，计算患者组双侧海马区代谢产物氮-乙酰天门冬氨酸（NAA）/肌酸（Cr）及海马容积、对照组任一侧海马NAA/Cr及容积，比较患儿病灶侧与病灶对侧、病灶侧与对照组、病灶对侧与对照组之间有否差异。分析癫痫发作频率等临床相关因素与海马萎缩的相关性。结果：患儿病灶侧海马区NAA/Cr（1.47±0.24）较病灶对侧（1.79±0.35）及对照组（1.81±0.27）明显减低，而病灶对侧NAA/Cr与对照组差异不明显；患儿病灶侧海马容积（2.75±0.35）较病灶对侧（3.06±0.46）和对照组（3.11±0.17）亦明显减小(对照组NAA/Cr值及海马容积参考值范围为标准）。此外，fTLE患儿癫痫发作频率与病灶侧海马容积缩小不具有相关性，而热惊厥史对海马体积具有显著影响。结论：3.0T 1H-MRS及vMR测量对儿童局灶性颞叶癫痫病灶具有定位作用，并且能够定量反映患儿海马代谢性异常及形态学改变，是为临床诊治提供可靠依据的无创性检查手段。

3.0T 1H-MRS and MRI volumetry analysis in the hippocampus of children with focal temporal lobe epilepsy

Objective:To study the diagnostic value of quantitative proton magnetic resonance spectroscopy(1H-MRS) and volumetric MR(vMR) in the hippocampus of children on focal temporal lobe epilepsy(fTLE),and analyse the relationship between the volume change of the hippocampus and clinical factors.Methods:3.0T 1H-MRS and vMRI were used to study 30 children(mean age 8.5 years,age 5 to 14 years) with unilateral fTLE,proven by 24 hours active electroencephalogram,and 30 random healthy children(mean age 8.8 years,age 5 ...