摘要
目的:探讨与研究头颅磁共振成像(MRI)对癫痫致痫灶的定位评估的价值。方法:选择癫痫患者82例作为癫痫组,同期选择健康志愿者82例作为对照组,所有患者都给予头颅常规MRI与氢质子磁共振波谱(~1H-MRS)成像,记录影像学特征、定位致痫灶并判定诊断价值。结果:癫痫组MRI显示海马体积较对侧缩小,神经元细胞有不同程度的变性、减少或缺失,侧脑室颞角较对侧扩大,海马头部浅沟消失。癫痫组的MRI图像评分多为1分与2分,与对照组对比差异有统计学意义(P<0.05)。癫痫组的~1H-MRS N-乙酰天门冬氨酸(NAA)/胆碱(cho)、NAA/肌酸(Cr)和NAA/(Cr+Cho)水平都明显低于对照组,差异有统计学意义(P<0.05)。在82例癫痫患者中,病MRI判断为致痫灶80处,其中颞叶51例,额叶17例,扣带回后部5例,顶叶病变5例,岛叶2例,头颅MRI对癫痫致痫灶的定位评估的准确性为92.7%。ROC曲线显示头颅MRI对癫痫致痫灶的定位评估的曲线下面积为0.750。结论:头颅MRI在癫痫患者的应用能有效反映病灶信号特征与物质代谢信息特征,对癫痫致痫灶的定位评估具有很高的准确性,诊断价值也比较高。
Objective To explore and study the values of cranial magnetic resonance imaging(MRI) for localization and assessment of epileptogenic foci in epilepsy. Method A total of 82 cases of epilepsy patients were selected as the epilepsy group, and 82 cases of healthy volunteers were selected as the control group during the same period. The MRI and ~1H-hydrogen proton magnetic resonance spectroscopy(~1H-MRS) in the all cases were imaged, recorded imaging features, locate epileptogenic foci and determined the diagnostic value. Results MRI of epilepsy group showed that the volume of the hippocampus was smaller than that of the contralateral side, the neuron cells were degenerated, decreased or lost to different degrees, the temporal horn of the lateral ventricle were enlarged compared to the contralateral side, and the superficial sulcus of the hippocampus head disappeared. The scores of MRI images in the epilepsy group were mostly 1 and 2 points, and the difference were statistically significant compared with the control group(P<0.05). The levels of ~1H-MRS N-Acetyl aspartate(NAA)/choline(cho), NAA/creatine(Cr) and NAA/(Cr+Cho) in the epilepsy group were all significant lower than the control group(P<0.05). In the 82 epilepsy patients, there were 80 cases of epileptogenic foci were identified by disease MRI, included cases of 51 in the temporal lobe, 17 cases of in the frontal lobe, 5 cases of in the posterior cingulate, 5 cases of in the parietal lobe, and 2 cases of in the insula. The accuracy of localization assessment of epileptogenic foci were 92.7%. The ROC curve showed that the area under the curve of cranial MRI for localization assessment of epileptogenic foci were 0.750.Conclusion The application of cranial MRI in epilepsy patients can effectively reflect the signal characteristics of the lesions and the information characteristics of material metabolism, and has high accuracy in the localization and evaluation of epilepsy-causing foci, and the diagnostic value is also relatively high.
作者
张楠
徐建侠
ZHANG Nan;XU Jian-xia(CT-MR Room,East District of Jiamusi Central Hospital,Jiamusi 154002,China)
出处
《吉林医学》
CAS
2022年第10期2786-2789,共4页
Jilin Medical Journal
关键词
磁共振成像
氢质子磁共振波谱
癫痫
致痫灶
物质代谢
诊断价值
Magnetic resonance imaging
Proton magnetic resonance spectroscopy
Epilepsy
Epileptogenic foci
Substance metabolism
Diagnostic value
