摘要
目的:分析丘脑、岛叶、基底核区的代谢物和水分子弥散异常在特发性全面强直阵挛发作型癫(PGTCS)发病中的意义。方法:对30例PGTCS患者(PGTCS组)进行发作间期的MRS采集,半定量分析丘脑、岛叶、基底核区的NAA、Cho、Cr;用NHS3量表对病情程度进行量化评分,计算NAA/Cr值、NAA/(Cho+Cr)值与癫严重程度的相关性;行DWI检查,观测相应兴趣部位的ADC值的变化;设对照组30例与之比较。结果:与对照组比较,PGTCS组双侧丘脑NAA/Cr值、NAA/(Cr+Cho)值均明显降低(P<0.05),而双侧基底核区、岛叶NAA/Cr值、NAA/(Cr+Cho)值无明显变化;PGTCS组双侧丘脑NAA/Cr值、NAA/(Cr+Cho)值与NHS3量表评分呈负相关;PGTCS组双侧丘脑、岛叶、基底核区ADC值均明显高于对照组,具有统计学意义(P<0.05)。结论:PGTCS患者丘脑存在神经元丧失及胶质细胞增生,提示丘脑可能为发作间期癫形成的相关脑区,或是长期癫发作的脑损伤区;1H-MRS能较准确地反映PGTCS患者发作造成的脑损伤;DWI能敏感地反映PGTCS癫发作间期存在水分子弥散增加的病理生理改变。
Objective：To explore the relationship between metabolites and ADC values of the thalamus,basal ganglia,and insular lobe system with the primarily generalized tonic-clonic seizure（PGTCS）.Methods： 30 PGTCS were evaluated by seizure severity scale（NHS3）.All the patients＇ metabolites were measured by MRS during seizure interval and NAA,Cr and Cho in the thalamus,basal ganglia and insular lobe were half-quantitative analyzed.The scores of NHS3,NAA/Cr and NAA/（Cr＋Cho） of patients were documented.According to DWI,ADC values were observed in corresponding areas.All the parameters were compared between the control and PGTCS groups.Results：Compared to those in the control group,The NAA/Cr and NAA/（Cr＋Cho） values in thalamus in the PGTCS group were significantly decreased（P0.05）,but there was no difference in basal ganglia and insular lobes between the two groups（P0.05）.There was a negative correlation between the ratio of NAA/Cr、NAA/（Cr＋Cho） and the scores of NHS3.The ADC values of two sides thalamus,basal ganglia and insular lobes in the PGTCS group were significantly higher than those of the control group（P0.05）.Conclusion： The changes in the thalamus indicated the loss of neurons and hyperplasia of astrocytes.The abnormality of NAA/Cr and NAA/（Cr ＋Cho） in the thalamus with PGTCS suggests that the thalamus might be the correlated encephalic region of epileptic seizures or injured cerebral zone caused by long time seizures.The MRS could reflect the injure degree in PGTCS patients.DWI could sensitively reflect the changed in pathologic physiology,especially the increased water diffusion during the interval of seizures.
出处
《神经损伤与功能重建》
2009年第6期408-411,共4页
Neural Injury and Functional Reconstruction
