3.0T磁共振波谱对颞叶癫痫的定侧诊断价值

目的：通过对颞叶癫痫的磁共振波谱研究，探讨3.0T超高场强MRS在颞叶癫痫的定侧诊断价值。方法对40例临床诊断颞叶癫痫患者及20例正常志愿者进行研究，所有实验对象行双侧海马的常规MRI和1H-MRS扫描，MR成像序列为轴位SE T1WI、T2WI，对双侧海马体部进行多体素波谱成像，将正常对照组MRS结果作为标准，评价颞叶癫痫患者MRS代谢物比值特点，分析MRS对颞叶癫痫定侧诊断价值。结果常规MRI诊断海马硬化共21例。癫痫组患侧、健侧与对照组间NAA/（Cho＋ Cr）、NAA/ Cho比值差异均有统计学意义（F分别=12.89、15.73，P均＜0.05）。癫痫组患侧与健侧、患侧与对照组NAA/（Cho＋Cr）、NAA/Cho差异均有统计学意义（q分别=7.32、8.47、7.33、8.47，P均＜0.05）；而癫痫组健侧与对照组差异无统计学意义（q分别=1.13、1.13，P均＞0.05）。结论常规MRI检查对颞叶癫痫的定侧具有一定的价值；3.0T超高场强MRS与常规MRI联合应用可以提高颞叶癫痫定侧的准确性。

Lateralization with 3.0T magnetic resonance spectroscopy in temporal lobe epilepsy

Objective To evaluate the value of 3.0T magnetic resonance spectroscopy（MRS） in localization diagnosis of temporal lobe epilepsy. Methods Conventional MRI and MRS were performed on the hippocampuses of 20 healthy volunteers and 40 patients with temporal lobe epilepsy. MR image was performed with T1-weighted spin-echo, T2-weighted spin-echo, fluid-attenuated inversion-recovery, and MR spectroscopy. Sensitivity of 3.0T MRS in localization diagnosis of temporal lobe epilepsy was analyzed. Results Hippocampus sclerosis was diagnosed in 21 hippocampuses with conventional MRI. There were statistical differences in mean value of NAA/（Cho＋ Cr） and NAA/Cho among these three conditions （F=12.89,15.73,P〈0.05）. Mean value of NAA/（Cho＋ Cr） and NAA/Cho showed statistical differences between lesion side and contralateral side of temporal lobe epilepsy, and between lesion side of temporal lobe epilepsy and healthy volunteers（q=7.32,8.47,7.33,8.47,P〈0.05）. However, mean value of NAA/（Cho＋ Cr） and NAA/Cho showed no statistical differences between contralateral side of temporal lobe epilepsy and healthy volunteer （q=1.13,1.13,P〉0.05）. Conclusion Conventional MRI is useful for localization diagnosis of temporal lobe epilepsy. Accuracy of localization diagnosis of temporal lobe epilepsy could be improved by conventional MRI in combination with 3.0T MRS.