摘要
目的探讨短时反转恢复（STIR）序列在诊断海马硬化（HS）中的临床应用价值。方法21例经常规MRI扫描排除了占位性和损伤性病变的内侧颞叶癫痫患者纳入研究。采用STIR技术，进行冠状位、轴位和矢状位成像，依照海马体积的缩小、信号改变、海马内部结构的丧失和侧脑室颞角扩大的海马硬化判断标准，分析比较常规MRI序列和STIR序列的成像结果，并进一步分析6例接受手术切除治疗患者海马的影像-病理相关性。结果常规MRI序列能较好地显示海马的体积改变和信号的改变，但是对于海马内部结构显示不清。经常规MRI诊断14例（66．7％）为一侧HS，4例为一侧可疑HS。而STIR序列能够清晰显示海马内部结构，正常海马可以观察到下托到CA1区并延续到CA2区的线样稍低信号影，呈现“C”字征；而在HS中此信号消失，同时在CA4区，呈现低信号区域。18例（85．7％）经STIR诊断为HS。来自6例手术患者的影像-病理分析显示，“C”字征信号消失与CA1区锥体神经细胞脱失相关，而CA4区低信号则反映了胶质增生。结论STIR序列的高分辨率可以可靠地显示海马的细微解剖结构，优于常规的MRI序列，在诊断HS中具有重要价值。
Objective To evaluate the utility of short tau inversion recovery （STIR） sequence in the diagnosis of hippocampal sclerosis （ HS ）. Methods Twenty-one patients with medial temporal lobe epilepsy without neoplasm lesions or injuries by conventional MRI sequence including T1WI, T2WI and FLAIR were included in this study. STIR imaging in axial, coronal and sagittal sequences was performed on these patients. Diagnosis of HS was based on the findings of hippocampal atrophy, alteration signal, disturbed internal structure and enlargement of the inferior horn. The findings shown on conventional MRI were compared with those on STIR sequence. Furthermore, the correlation of radiologic and histological findings was investigated in 6 patients operated for refractory seizures. Results On conventional MRI sequence, 14 patients （66. 7% ） were confirmed with unilateral HS and 4 patients were suspected with unilateral HS. In contrast, all these 18 patients （85.7%） were confirmed with unilateral HS by STIR. Particularly, STIR sequence delineated the internal structure of hippoeampus more clearly than conventional MRI sequences did. ＂C＂ shaped contour in subieulum-CA1 -CA2 was revealed in normal hippocampus on STIR sequence and disappeared in HS, correlated to the pathology finding of loss of neuron in CA1 in resected tissues in 6 operated patients. The patients with HS also showed areas of hypodensity in CA4 on STIR, in accordance with pathologic findings of gliosis in this area in the 6 operated patients. Conclusion STIR sequence could depict the internal anatomical structure of hippoeampus with high resolution superior to conventional MRI sequences, and can be of great value in the diagnosis of HS.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2012年第9期669-673,共5页
Chinese Journal of Neurology
基金
国家自然科学基金面上项目（31070905）
关键词
海马
硬化
癫痫
颞叶
诊断显像
短时反转恢复
Hippoeampus
Sclerosis
Epilepsy, temporal lobe
Diagnostic imaging
Short tau inversion recovery
