摘要
目的 探讨海马氢质子磁共振波谱分析（^1 H-MRS）在儿童颞叶癫（癎）（TLE）诊断中的价值.方法 采用GE公司Singa HDe至臻版1.5T磁共振成像仪,对30例TLE患儿（TLE组）和30例健康儿童（健康对照组）行颅脑MRI和海马单体素^1H-MRS检查.观察海马N-乙酰天门冬氨酸（NAA）、肌酸（Cr）、胆碱（Cho）水平,分析NAA/（Cho＋ Cr）、NAA/Cr及NAA/Cho比值.分别对患侧、健侧及健康对照组儿童海马生化成分进行分析.结果 MRI结合MRS发现海马区异常28例.TLE组患侧与健侧、健康对照组NAA/（Cho＋ Cr）、NAA/Cr及NAA/Cho比较差异均有统计学意义（P均＜0.05）,而健侧与健康对照组比较差异均无统计学意义（P均＞0.05）.19例行手术证实,术后病理学改变：镜下可见脑表面呈波浪状,皮质厚薄不均；皮质内可见巨大神经元、未成熟神经元,散见形态异常神经元；白质内可见少量异位神经元.结论 TLE患儿患侧海马的NAA/（Cho＋ Cr）值降低,可早期诊断海马硬化,为临床诊断和治疗儿童TLE提供证据.
Objective To explore the value of hippocampus hydrogen proton magnetic resonance spectrum analyzes （^1 H-MRS） for the diagnosis of temporal lobe epilepsy （TLE） in children.Methods Singa HDe GE company to attain the 1.5T magnetic resonance imaging apparatus was used to analyze the conditions of 30 cases of children with TLE and the other 30 healthy controls received brain MRI and ^1H-MRS check.The hippocampal N acetyl aspartate （NAA）,creatine （Cr）,and the choline （Cho） concentration were observed; NAA/（Cho ＋ Cr）,the ratio of NAA/Cr and NAA/Cho were analyzed.The analysis of biochemical components in the hippocampus was performed on the affected sides and the healthy sides of TLE group and the sides of the healthy control group,respectively.Results Hippocampus were anormal by combining MRI and MRS in 28 cases.Levels of NAA/（Cho ＋ Cr）,NAA/Cho,and NAA/Cr in the trouble sides of the TLE group had the remarkable statistical significance compared with the normal sides,and the healthy control group （all P 〈 0.05）,but there was no remarkable statistic significance between the normal sides and the healthy control group （all P 〉 0.05）.Nineteen cases had been confirmed by surgery,and postoperative pathological changes：brain surface were wavy,cortex were uneven;there were giant neurons,immature neurons,and scattered across the deformity of neurons in the cortex.A small amount of ectopic neurons can be seen in white matter.Conclusions In the TLE children,the reduction of NAA/（Cho ＋ Cr） value of the side hippocampus may help diagnose the hipppcampal sclerosis earlier,and can provide significant evidence for the diagnosis and treatment of TLE in children.
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2013年第18期1412-1414,共3页
Chinese Journal of Applied Clinical Pediatrics
关键词
颞叶癫（癎）
海马
磁共振波谱
Temporal lobe epilepsy
Hippocampus
Magnetic resonance spectroscopy
