摘要
目的探讨在磁共振质子波谱分析(1HMRS)对颞叶癫疒间的定侧作用及其影响因素。方法用1.5T场强的MR成像系统1HMRS,对40例不同病程的颞叶癫疒间患者和20名正常对照者分别进行双颞叶内侧N乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)浓度测定,根据颞叶癫疒间患者两侧NAA/(Cho+Cr)值进行定侧。结果NAA/(Cho+Cr)值正常对照组为0.58±0.09,癫疒间组病灶侧为0.45±0.12,病灶对侧为0.51±0.10,癫疒间组两侧显著小于正常对照组(均P<0.05);24例患者1HMRS癫疒间灶定侧与EEG一致,符合率63%;病灶侧内、中、外各亚区NAA/(Cho+Cr)值较正常对照组低,差异有显著性(均P<0.05);病灶侧NAA/(Cho+Cr)值下降程度与单或双侧NAA/(Cho+Cr)值下降及发作频率无关(P>0.05);双侧NAA/(Cho+Cr)值异常者两侧EEG异常率高于单侧异常者(P<0.05);病灶侧NAA/(Cho+Cr)值与病程呈负相关(r=-0.361,P<0.05)。结论癫疒间患者脑代谢异常弥散;1HMRS在颞叶癫疒间有定侧作用;NAA/(Cho+Cr)值与病程呈负相关。
Objective To investigate the role of proton magnetic resonance spectroscopy （^1H-MRS） in accurate lateralization of temporal lobe epilepsy （TLE） and the factors which influenc ^1H-MRS in epileptogenic zones, Methods ^1H MRS and MRI were performed in 40 patients with TLE and 20 healthy volunteers by 1.5T MR/MRS system. The data of spectra of N-acetylaspartate （ NAA）, creatine ＋ phosphocreatine （Cr） and choline-containing compounds （Cho） obtained from the medial regions of the temporal lobes were analyzed, Lateralization of TLE with ^1H-MRS was defined by the ratio of NAA/（ Cho ＋ Cr）. Results The ratios of NAA/（ Cho ＋ Cr） both in epileptogenic zones （0. 45± 0. 12） and contralateral regions （0. 51± 0. 10） were lower than that in control group （0.58±0. 09）（ P 〈0. 05 ）. Epileptogenic focus in 24 patients lateralized by ^1H-MRS was the same by EEG, the coincidence was 63%, NAA/（ Cho ＋ Cr） in inside, media, lateral epileptogenic lateralization was lower than that in controls （P 〈0.05）. The decrease of NAA/（ Cho ＋ Cr） in epileptogenic side was not related to the decrease of NAA/（ Cho ＋ Cr） in unilateral or bilateral side and seizure frequency （ P 〉 0. 05 ）, There was significant difference in bilateral abnormal EEG between bilateral abnormal NAA/（ Cho ＋ Cr） and unilateral abnormal NAA/（ Cho ＋ Cr） （ P 〈 0, 05 ）. Seizure duration had negative correlation with NAA/（ Cho ＋ Cr） in epileptogenic lateralization （r = -0. 361, P 〈 0.05 ）. Conclusions Abnormal brain metabolism in TLE is diffused. ^1H-MRS may lateralize TLE, and the ratio of NAA/（ Cho ＋ Cr） in epileptogenic zones is negatively related to the course of disease.
出处
《临床神经病学杂志》
CAS
北大核心
2006年第4期253-256,共4页
Journal of Clinical Neurology
关键词
颞叶癫痫
磁共振质子波谱分析
多体素
temporal lobe epilepsy
proton magnetic resonance spectroscopy
muhi-voxel
