摘要
目的比较颞叶癫致灶3 T和7 T MR成像差异,并与病理结果对照分析,以确定7 T MRI在呈现、检测病变中的意义。方法共纳入2014年1月—2017年12月期间确诊的34例颞叶癫病人[男18例,女16例;平均年龄(27±8)岁]及5名正常对照(男3名,女2名;平均年龄27岁),均行术前3 T和7 T MR扫描,全部病人均获术后病理结果。由2名高年资放射科医师对术前影像和病理结果进行对照分析,并对病理为海马硬化(HS)者的海马内部结构进行评分。采用配对t检验对3 T和7 T MRI上双侧海马内部结构评分进行比较。结果 34例病人中,病理诊断为HS者24例,其中20例在3 T及7 T MRI上诊断明确,4例MRI术前诊断欠明确。3 T和7 T MRI上,患侧海马内部结构评分均低于正常侧(P<0.001)。7 T MRI上海马内部结构评分均高于3 T MRI(P<0.05)。局灶性皮质发育不良(FCD)6例(FCDⅠ_a2例、FCDⅢ_a3例、FCDⅢ_d1例)。颞叶FCDⅠa在3 T及7 T MRI上均未发现,FCDⅢa及FCDⅢd海马区病灶在3 T MRI及7 T MRI上均清楚显示。海马占位4例(节细胞胶质瘤2例,脑膜瘤1例,左侧杏仁体部分区域胶质细胞增生1例)在3 T和7 T MRI均清楚显示。对5例正常对照脑部结构的显示,7 T MRI优于3T MRI。结论典型病灶在3 T及7 T MRI均可发现,7 T MRI对海马内部精细结构的显示优于3 T MRI;不典型病灶7 T MRI能够更好地显示解剖精细结构,但有些病灶如FCDⅠ_a仍无法分辨。
Objective To determine the ability of 7 T MRI in detecting and presenting lesions by comparing the difference in performance between 3 T and 7 T MRI in patients with temporal lobe epilepsy using pathological results as reference. Methods From January 2014 to December 2017, we performed 3 T and 7 T MR scans on 34 patients with temporal lobe epilepsy（male 18, female 16; mean age 27±8 years） and 5 normal controls（male 3, female 2; mean age 27 years）. All patients underwent surgery and had pathological analysis. Preoperative MRI images were interpreted by two experienced neuroradiologists using pathological results as a reference. Scores of the bilateral hippocampal internal architecture（HIA） were assessed in the patients with pathological result of hippocampal sclerosis. Difference in HIA scores between 3 T and 7 T MRI was evaluated by paired t test. Results Among the 34 patients, 24 cases were diagnosed with hippocampal sclerosis pathologically, 20 of the 24 cases presented typical hippocampal sclerosis on both 3 T and 7 T MRI,and the remaining 4 cases had certain diagnosis on neither 3 T nor 7 T MRI. Among these patients, HIA scores of the epileptogenic hippocampi assessed on 3 T and 7 T MRI were significantly lower than that of contralateral hippocampi（P〈0.001）. The HIA scores assessed on 7 T MRI were significantly higher than those assessed on 3 T MRI（P〈0.05）. Six cases were diagnosed with focal cortical dysplasia（FCD Ⅰa,n=2;FCD Ⅲan=3;FCD Ⅲd,n=1）. Hippocampal lesions of FCD Ⅲaand FCD Ⅲdwere presented on both 3 T and 7 T MRI, but all FCD Ⅰa lesions were not detectable on 3 T and 7 T MRI. Four cases were pathologically diagnosed with mass in hippocampus（gangliogliomas n =2, meningioma n =1, left amygdala glial cellhyperplasia n=1）, which were all clearly appeared on 3 T and 7 T MRI. In the 5 controls, brain structure on 7 T was more clearly presented compared with the 3 T MRI. Conclusion The typical lesions can be clearly presented on both 3 T and 7 T MRI. 7 T MRI was relatively superior to 3 T MRI in displaying the subtle HIAs. For atypical lesions, 7 T MRI can present the subtle structures better, but not for some lesions such as FCD Ⅰa.
作者
张一玮
毛晨晖
有慧
窦万臣
冯逢
ZHANG Yiwei;MAO Chenhui;YOU Hui;DOU Wanchen;FENG Feng(Department of Radiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)
出处
《国际医学放射学杂志》
北大核心
2018年第6期662-667,共6页
International Journal of Medical Radiology
基金
国家自然科学基金面上项目(81271544)
关键词
颞叶癫癎
磁共振成像
超高场强
病理
Temporal lobe epilepsy
MRI
Ultra high field
Pathology
