应用FAIR技术评价难治性和非难治性颞叶癫痫灌注异常

目的用FAIR技术评价难治性及非难治性颞叶癫痫患者发作间期rCBF异常的模式是否不同.方法 9例难治性颞叶癫痫、21例非难治性颞叶癫痫患者及13名正常志愿者,测量其双侧大脑半球及双侧内侧颞叶的rCBF,并计算不对称指数(AI).结果难治性及非难治性癫痫患者大脑半球AI值与正常对照组之间有统计学差异(P值分别为0.012和0.029);难治性颞叶癫痫患者内侧颞叶AI值与正常对照组之间无统计学差异(P＝0.102),而非难治性癫痫患者与正常对照组之间有统计学差异(P＝0.049).结论难治性和非难治性颞叶癫痫患者发作间期rCBF异常的模式有所不同,虽然均可出现较广泛的rCBF异常,但难治性癫痫更倾向于出现双侧内侧颞叶低灌注,这可为判断预后提供帮助.

Differences in interictal perfusion patterns between refractory and non-refractory temporal lobe epilepsies evaluated with FAIR techniques

Objective To evaluate whether there is difference in interictal perfusion patterns between refractory and non-refractory temporal lobe epilepsies. Methods Nine patients suffered from refractory temporal lobe epilepsy, 21 patients suffered from non-refractory temporal lobe epilepsy and 13 normal volunteers underwent FAIR MR scanning. The rCBF (relative cerebral blood flow) in bilateral hemispheres and mesial temporal lobes were measured. And then the asymmetry index (AI) values were calculated. Results The AI values of bilateral hemispheres of refractory and non-refractory epilepsy patients were both significantly different from those of volunteers. There was significant difference in AI values of bilateral mesial temporal lobes between non-refractory epilepsy patients and volunteers, and no significant difference between refractory epilepsy patients and volunteers. Conclusion The hypoperfusion pattern is different between interictal refractory and non-refractory temporal lobe epilepsy patients. In both patients' groups, the hypoperfusion tends to extend out of temporal lobes. But the refractory epilepsy patients have a preference of bilateral mesial temporal hypoperfusion. This may be valuable for evaluating prognosis.