摘要
目的:评价磁共振质子波谱和利物浦痫性发作严重程度量表反映的痫性脑损伤程度是否一致,为颞叶癫痫的早期诊断治疗提供依据。方法:选择2003-10/2004-03在武汉大学中南医院收治颞叶癫痫患者11例,以11例健康自愿者为正常对照组。所有被试者进行常规头颅MRI检查后,采用磁共振质子波谱检测其双侧近中颞叶脑组织,半定量分析N-乙酰天门冬氨酸、肌酸、胆碱复合物、乳酸等化学物质;比较MRI与磁共振质子波谱对致痫灶侧的早期检出率;并采用利物浦痫性发作严重程度量表(分值在0~100,分值越高说明发作程度越重)评估痫性发作严重程度;同时观察N-乙酰天门冬氨酸/(肌酸+胆碱复合物)比值与痫性发作严重程度的相关性。结果:按意向处理分析,22例被试者均进入结果分析。①N-乙酰天门冬氨酸/(肌酸+胆碱复合物)比值:癫痫组致痫灶侧明显低于对侧和正常对照组(0.522±0.031,0.749±0.034,0.754±0.039,P<0.01);致痫灶对侧与正常对照组无差异(P>0.05)。②对致痫灶侧的早期检出率:磁共振质子波谱较磁共振高(100%比63.64%,P<0.05)。③致痫灶侧N-乙酰天门冬氨酸/(肌酸+胆碱复合物)比值与利物浦痫性发作严重程度量表得分具有显著相关性(r=0.969)。结论:与磁共振成像相比,磁共振质子波谱能早期、准确地反映癫痫发作造成的脑损伤,利物浦痫性发作严重程度量表评分与N-乙酰天门冬氨酸/(肌酸+胆碱复合物)比值能一致反映痫性脑损伤的严重程度。
AIM :To appraise the consistency of estimating the degree of brain seizure injury by proton magnetic resonance spectroscopy (1^H-MRS) and Liverpool seizure severity scale (LSSS), and provide evidences for the early diagnosis and treatment of temporal lobe epilepsy. METHODS:Eleven patients with temporal lobe epilepsy, who treated in the Zhongnan Hospital of Wuhan University from October 2003 to March 2004, were selected, and another 11 healthy volunteers were selected as control group. After examined by routine brain MRI, the bilateral mesial temporal lobe tissues of all the testees were examined by 1H-MRS. Chemical materials including N-acetylaspartate (NAA),creatine (Cr),choline (Cho), lactate (Lac) etc. were conducted with half-quantitative analysis. The earlier check rates of MRI and ^1H-MRS on injured focus side were compared. The severe degree of seizure was evaluated by LSSS (the score was between 0 and 100; the higher the score, the more severe the seizure degree was); The correlation of ratio of NAA/ (Cr+ Cho) and the severe degree of seizure was observed at the same time. RESULTS :According to the intention-to-treat analysis, 22 testees were all involved in the result analysis. ① The ratio of NAA/(Cr+ Cho): It was significantly lower in the focus of the epilepsy group than that in the opposed side and the normal control group (0.522 ±0.031, 0.749 ±0.034, 0.754 ±0.039, P 〈 0.01 ); There was no difference in the opposed side and the normal control group (P 〉 0.05). ② The earlier check rate of the seizure focus side: It was higher of the ^1H-MRS than that of the magnetic resonance (100% vs 63.64%, P 〈 0.05). ③ There was significant correlation of the ratio of NAA/(Cr+Cho) and the severe degree score of LSSS seizure r=0.969). CONCLUSION:Compared with MRI, the ^1H-MRS can accurately refect the brain injury induced by seizure in an earlier period. The LSSS and ratio of NAA/(Cr+ Cho) can coincidently reflect the severe
出处
《中国临床康复》
CSCD
北大核心
2005年第29期21-23,共3页
Chinese Journal of Clinical Rehabilitation