摘要
目的探讨集成磁共振成像(SyMRI)技术在颞叶内侧癫痫伴海马硬化(HS)中各亚区的定量研究价值。资料与方法前瞻性纳入2021年1月—2023年1月宁夏医科大学总医院经MRI诊断或病理证实为单侧HS的患者(病例组)28例,并纳入同期健康志愿者(对照组)38例。两组对象均于3.0T MRI行T1加权等体素三维磁化强度预备梯度回波序列及集成MRI序列扫描。扫描图像分别经freesurfer V7、SyMRI StandAlone 8.0.4后处理得到海马及其亚区的感兴趣区及T1、T2、质子密度(PD)定量图,二者融合得到T1、T2、PD值。比较HS患侧组、健侧组及对照组各项参数值并进行多重比较。对组间差异有统计学意义的参数采用逐步回归分析筛选出显著性变量,并采用受试者工作特征曲线下面积评价其诊断效能。结果3组间下托(SUB)的T1和PD值差异无统计学意义(F=1.819、0.570,P均>0.05),其余亚区各参数差异均有统计学意义(F/H=5.539~71.570,P均<0.05)。组间两两比较显示,患侧组CA1、CA3、CA4、齿状回的T2、T1值均高于健侧组及对照组,PD值高于对照组,患侧组SUB的T2值高于对照组,患侧组CA3的PD值高于健侧组(P均<0.05)。逐步回归法显示CA1、CA3、SUB的T2值为显著性变量(模型调整后R2=0.828,F=105.089,P<0.001,方差扩大因子=2.693、2.113、1.721)。CA1、CA3区T2值的曲线下面积最大,均为0.972,截断值、敏感度、特异度分别为101.42 ms、92.86%、100%,95.56 ms、92.86%、92.11%。结论SyMRI对颞叶内侧癫痫伴HS海马亚区组织弛豫时间的定量测量可为临床提供更加精准的影像学参考依据,尤其是CA1、CA3区T2值可有效提高HS的诊断效能。
Purpose To investigate the value of synthetic magnetic resonance imaging(SyMRI)in the quantitative study of various subregions in medial temporal lobe epilepsy(MTLE)with hippocampal sclerosis(HS).Materials and Methods Twenty-eight patients with unilateral HS diagnosed by MRI or pathologically confirmed in General Hospital of Ningxia Medical University from January 2021 to January 2023 were included as a case group,gender-and age-matched 38 healthy volunteers in during the same period were included as a control group.All subjects underwent T1-weighted equal voxel three-dimensional magnetisation-prepared rapid gradient-echo and synthetic magnetic resonance imaging scans on a 3.0T MRI machine.The scanned images were processed with freesurfer V7 and SyMRI StandAlone 8.0.4 to obtain the regions of interest and T1,T2 and PD quantitative maps of the hippocampus and its subregions.The T1,T2 and PD values were obtained from fusion of the two results.The values of all parameters in the affected,contralateral side of HS and control groups were compared,and multiple comparisons were further performed.Parameters with statistically significant differences between groups were screened for significant variables using stepwise regression analysis,and the diagnostic efficacy of significant parameters was evaluated via the area under the curve.Results The differences among three groups were statistically significant(F/H=5.539-71.570,all P<0.05)for each parameter value in all sub-regions,except for T1 and PD values in the subiculum(SUB),which were not statistically significant(F=1.819,0.570,both P>0.05).The post hoc analysis showed that the T2 and T1 values of CA1,CA3,CA4,and dentate gyrus of the affected group were significantly higher than those of the contralateral side group and the control group,and the PD values of the affected group were significantly higher than those of the control group;the T2 values of SUB of the affected group were significantly higher than those of the contralateral side group,and the PD values of CA3 of the affected group were significantly higher than those of the healthy group(all P<0.05).The stepwise regression method showed that the T2 values of CA1,CA3,and SUB were significant variables(model adjusted R^(2)=0.828,F=105.089,P<0.001,variance inflation factor=2.693,2.113,1.721).The area under the curve of T2 of CA1 and CA3 regions was the largest,both 0.972,and their cut-off values,sensitivity and specificity were 101.42 ms,92.86%,100%;95.56 ms,92.86%,and 92.11%,respectively.Conclusion The quantitative measurement of tissue relaxation time in hippocampal subregions of MTLE-HS patients via SyMRI can provide a more accurate clinical imaging reference,especially the T2 values of CA1 and CA3 regions can effectively improve the diagnostic efficacy of HS.
作者
王一婷
闫梦楠
摆玉财
李健
熊昱辉
陈兵
WANG Yiting;YAN Mengnan;BAI Yucai;LI Jian;XIONG Yuhui;CHEN Bing(Department of Radiology,General Hospital of Ningxia Medical University,Yinchuan 750004,China;不详)
出处
《中国医学影像学杂志》
CSCD
北大核心
2023年第11期1127-1132,1144,共7页
Chinese Journal of Medical Imaging
基金
宁夏回族自治区重点研发计划(2020BEG03026)
关键词
癫痫
颞叶内侧
海马硬化
集成磁共振成像
海马自动分割
Epilepsy
Medial temporal lobe
Hippocampal sclerosis
Synthetic magnetic resonance imaging
Hippocampal automatic segmentation
