10例特发性全身性癫痫患者丘脑磁共振波谱变化  

Changes of proton magnetic resonance spectroscopy in thalamus of 10 patients with idiopathic generalized epilepsy

作　　者：王怡[1] 黎海涛[1] 李露斯[2] 史树贵[2] 何海涛[1] 黎川[1] 

机构地区：[1]第三军医大学西南医院放射科,重庆400038 [2]第三军医大学西南医院神经内科

出　　处：《第三军医大学学报》2007年第10期967-969,共3页Journal of Third Military Medical University

摘　　要：目的观察特发性全身性癫痫(idiopathic generalized epilepsy,IGE)患者丘脑组织的N-乙酰天门冬氨酸(N-aceytl aspartate,NAA)、胆碱(choline,Cho)、肌酸(creatine,Cr)代谢物质的变化,探讨其在癫痫发病中的作用及意义。方法选取10例诊断明确的IGE患者,分别采集双侧丘脑的质子波谱,对NAA、Cr、Cho进行半定量分析,并用NHS3量表对病情程度进行量化评分,观察NAA/(Cr+Cho)值与癫痫严重程度的相关性。结果IGE组双侧丘脑NAA/Cr明显减少,NAA/(Cr+Cho)值明显低于正常对照组(P<0.05),且双侧NAA/(Cr+Cho)值与NHS3量表评分呈负相关(左侧:r=-0.644,P=0.022;右侧:r=-0.733,P=0.008)。结论IGE患者丘脑神经元丧失及胶质细胞增生可能是其共同的病理特征;NAA/(Cr+Cho)值下降与病情程度相平行;磁共振质子波谱能早期、准确地反映IGE患者发作造成的脑损伤,NHS3量表评分与NAA/(Cr+Cho)值能一致反映痫性脑损伤的严重程度。Objective To observe the change of N-aceytl aspartate （NAA）, creatine（Cr）, and chohne （Cho） in the thalamus of patients with idiopathic generalized epilepsy （IGE） and discuss the role and significance of the change in the pathogenesis of IGE. Methods Ten patients with IGE diagnosed specifically were enrolled in this study. Two-sides of proton magnetic resonance spectroscopy of the thalamus were recorded. NAA, Cr, and Cho were measured by semi-quantitative analysis. The degree of seizure was evaluated by seizure severity scale （NHS3）. The correlation between the ratio of NAA/（ Cr ＋ Cho） and the score of NHS3 were analysed. Results NAA/Cr levels in both sides of thalamus in IGE group were significantly declined. The ratio of NAA/（ Cr ＋ Cho） was lower in IGE group than normal control group （ P 〈 0. 05 ）, and there was a negative correlation between the ratio of NAA/（ Cr ＋ Cho） and the score of NHS3 （ left： r = - 0.644, P = 0. 022 ; right： r = - 0.733, P = 0. 008 ）. Conclusion The common pathologic features of IGE are the loss of neuron and hyperplasia of colloid cell. MRS can exactly reflect the pathologic lesion at early time. NHS3 and the ratio of NAA/（ Cr ＋ Cho） can reflect the degree of brain lesion elicited by seizure.

关 键 词：磁共振波谱 特发性全身性癫痫 量表 

分 类 号：R445.2[医药卫生—影像医学与核医学] R741.04[医药卫生—诊断学]