摘要
目的探讨磁共振波谱成像(1H-MRS)及弥散张量成像(DTI)在颞叶癫痫(TLE)中的影像表现特征。方法采用Philips3.0TMR对常规MRI检查阴性的28例TLE患者及22例与之年龄匹配健康志愿者行海马区域H-MRS检测及DTI成像;测量并比较病例组患侧、对侧和对照组之间海马的FA值、ADC值和波谱NAA/(Cho+Cr)比值,比较3组各参数均值是否存在差异。结果TLE患者患侧与对侧海马FA均值均较对照组降低,差异有统计学意义(P<0.05),但患侧与对侧之间差异无统计学意义(P>0.05);TLE患者患侧海马ADC均值高于对侧海马和对照组,且对侧海马ADC均值也高于对照组(P<0.05);TLE患者双侧海马NAA/(Cho+Cr)平均比值均低于对照组,差异有统计学意义(P<0.05),且患侧低于对侧,差异有统计学意义(P<0.05)。TLE患侧与正常对照组相比,相应年龄段内FA值累计降低14例,相似12例;ADC值升高16例,相似12例;NAA/(Cr+Cho)值降低21例,相似7例。结论在常规MRI阴性的TLE诊断中,1H-MRS及DTI均能够无创定量反映海马代谢及白质结构病理生理改变,在TLE患者定侧诊断中具有一定的价值。
Objective To investigate the imaging features of 1H-magnetic resonance spectroscopy ( 1H-MRS) and diffusion tensor imaging (DTI) in temporal lobe epilepsy (TLE). Methods 1H-MRS and DTI were performed in the hippocampus area among the 28 TLE patients with the negative result in routine MRI and the 22 healthy volunteers with the corresponding ages by Philips 3.0T MR. The values of FA and ADC and the spectroscopic NAA/(Cho+Cr) ratio of hippocampus in the affected and contralateral sides of the experiment group and the corresponding of the control group were measured sides and compared to investigate whether there were significant differences between the parameters. Results The mean values of FA in the affected and contralateral sides of TLE patients' hippocampus in the experiment group were significantly lower than those of the corresponding sides in the control group ( P <0.05), while there were no significant differences in the mean values of FA between the affected and contralateral sides ( P >0.05). The mean value of ADC in the affected side of TLE patients' hippocampus was significantly higher than the mean values of ADC in the contralateral side and the corresponding side of the control group ( P <0.05), and that in the corresponding side the contralateral side was significantly higher than that in the corresponding side of the control group ( P <0.05). The average ratio of NAA/(Cho+Cr) in the bilateral hippocampus of TLE patients was significantly lower than that in the corresponding side of the control group ( P <0.05), and that in the affected side was significantly lower than that in the contralateral side ( P <0.05). Compared with the normal control group, the FA value in the affected side of TLE patients' hippocampus was lower in 14 cases and similar in 12 cases, the ADC value was higher in 16 cases and similar in 12 cases, and the NAA/(Cho+Cr) ratio was lower in 21 cases and similar in 7 cases. Conclusion H-MRS and DTI can noninvasively and quantitatively reflect the metabolism of hippocampus and the pathophysiological changes of white matter structure in the TLE diagnosis with the negative results in routine MRI, so it has certain value in the localization diagnosis of TLE patients.
作者
杜飞舟
关静
蒋锐
Du Feizhou;Guan Jing;Jiang Rui(Medical Imaging Department, General Hospital of Western Theater Command, Chengdu 610083, China)
出处
《成都医学院学报》
CAS
2019年第4期431-434,439,共5页
Journal of Chengdu Medical College
基金
四川省科学技术厅资助项目(No:2018JY0604)
关键词
颞叶癫痫
海马硬化
磁共振波谱成像
弥散张量成像
Temporal lobe epilepsy
Hippocampus sclerosis
1H-magnetic resonance spectroscopy
Diffusion tensor imaging
