颞叶癫痫的1H MRSI和MRI体积测量研究

目的评价质子磁共振波谱成像(1H-MRSI)和MRI体积测量对颞叶癫痫(TLE) 的定侧诊断价值.方法对13例单侧TLE和13例对照者行MRI和1H-MRSI扫描,测量颞叶氮-乙酰天门冬氨酸(NAA)、肌酸(Cr)、胆碱(Cho)的浓度比率及海马结构体积.结果 TLE组8例海马结构萎缩,患侧海马结构NAA/Cr及NAA/(Cr Cho) 显著小于对侧及对照组(前者F=5.187,P=0.012;后者F=6.731,P=0.004);患侧颞叶外侧皮层的NAA/Cr显著小于对侧(t=-2.82, P=0.015).海马体积测量定侧敏感性为61.5%; 1H-MRSI定侧敏感性为84.6%.结论 1H-MRSI可发现颞叶广泛的代谢异常,增加定侧诊断敏感性.

1H MRSI and MRI volumetric measurement in temporal lobe epilepsy

Objective To investigate the ability of 1H MR spectroscopic imaging ( 1H MRSI) and MRI volumetric measurement in the lateralization of temporal lobe epilepsy (TLE). Methods Conventional MRI and 1H MRSI were performed in 13 patients with electroencephalogram (EEG) defined unilateral TLE and 13 normal subjects, the metabolic peak ratio of N acetylaspartate (NAA), Creatine (Cr), Choline (Cho) and the volume of hippocampal formation (HF) were measured. Results Hippocampal atrophy was found in 8 patients of TLE. The NAA/Cr and NAA/Cho+Cr were significantly lower in the ipsilateral hippocampus than that of the contralateral and control's hippocampus (the former: F =5.187, P =0.012;the later: F=6.731,P =0.004). The NAA/Cr in the ipsilateral temporal neocortex was significantly lower than that of contralateral temporal neocortex. The sensitivity of lateralization was 61.5% with MRI volumetric measurement, 84.6% with 1H MRSI combining hippocampus and temporal neocortex findings. Conclusion Both MRI volumetric measurement and 1H MRSI are effective tools for lateralization of TLE. The 1H MRSI discovers more extensive metabolic abnormality in temporal lobe, and improves the sensitivity of lateralization.