摘要
目的:探讨发作间期传统磁共振成像及弥散加权成像的对颞叶癫痫的定侧价值及其对患者术后疗效的预测能力。方法:27例准备手术的难治性颞叶癫痫患者及19例健康对照者行常规MRI及DWI检查。测量并分析颞叶癫痫患者及对照组双侧海马的ADC值。影像所见与术后切除的脑组织病理结果相对照。结果:颞叶癫痫患者手术侧海马的ADC值显著高于对侧及健康对照者的同侧海马。利用右/左侧海马ADC比值定侧与手术侧一致的患者为21例(77.8%),而常规MRI定侧与手术侧一致的患者为18例(66.7%),两者没有显著的统计学差异(P>0.05)。利用右/左侧海马的ADC比值能够定侧与不能定侧的两组癫痫患者术后疗效没有显著性差异(P>0.05)。结论:常规MRI是一种术前发现海马硬化的敏感方法。海马右/左侧ADC比值确定颞叶癫痫发作侧的准确性很高,但对患者术后癫痫控制情况的预测能力欠佳。
Objective：To investigate the value of interictal conventional MRI and diffusion-weighted imaging （DWI） to lateralize the seizure lesion of the temporal lobe and the ability to predict postoperative seizure control in patients with temporal lobe epilepsy （TLE）. Methods： Twenty-seven patients with intractable TLE considered for surgery and nineteen healthy volunteers were studied with conventional MRI and DWI. Apparent diffusion coefficients （ADC） of bilateral hippoeampal in both TIE patients and control subjects were obtained and analyzed. The imaging findings were compared with postoperative pathologic results. Results：Hippocampal ADCs were higher on the side of surgery compared with the eontralateral side as well as the ipsilateral side in control subjects. Right/left hippoeampal ADC ratio and conventional MRI lateralized to the operated temporal lobe in 21 of 27 （77.8%） and in 18 of 27 （66.7%） patients. Lateralization to the surgical side was not associated with postoperative seizure control with right/left Ifippocampal ADC ratio （ P 〉 0.05）. Conclusion： MRI is a sensitive method to detect hippeeampal sclerosis. Accuracy of the right/left hippocampal ADC ratio for lateralizing to the side of surgery was very high, but it was not a satisfactory predictor of surgical outcome.
出处
《医学影像学杂志》
2008年第9期965-968,共4页
Journal of Medical Imaging
关键词
颞叶癫痫
磁共振成像
弥散加权成像
MRI
Temporal lobe epilepsy Diffusion-weighted imaging
