常规MRI阴性青少年颞叶癫痫患者的短回波^1H-MRS研究  

Short Echo ^1H-MRS in Adolescent Temporal Lobe Epilepsy with Negative MRI Findings

作　　者：张丽[1] 沈加林[1] 许建荣[1] 戈欣[1] 刘佳[1] 

机构地区：[1]上海交通大学医学院附属仁济医院放射科,200127

出　　处：《临床放射学杂志》2008年第12期1636-1640,共5页Journal of Clinical Radiology

摘　　要：目的初步探讨单体素短回波点分辨率空间选择序列(point-resolved spatial selection,PRESS)氢质子磁共振波谱(1H-MRS)在常规MRI阴性的青少年颞叶癫痫(TLE)患者定侧诊断中的应用。资料与方法对常规MRI检查阴性的27例TLE患者及10名与之年龄匹配的健康志愿者行海马区域1H-MRS扫描和测量,并以癫痫患者24h脑电图(EEG)为致癫痫灶的定位指标,通过测定N-乙酰天门冬氨酸(NAA)/胆碱+肌酸(Cho+Cr)、谷氨酸盐(Glx)、肌醇(mI)分析其对MRI阴性TLE的定侧价值。结果27例TLE患者均完成1H-MRS扫描,22例谱线基线稳定,信噪比较好;22例癫痫患者1H-MRS结果与正常对照组测值平均值比较均发现异常,其中15例定侧与EEG符合。结论单体素短回波1H-MRS(PRESS序列)可以发现常规MRI阴性的TLE患者海马区脑组织代谢的异常,并能较好地定侧,为临床诊断致癫痫灶提供帮助。Objective To evaluate the value of Hydrogen 1 Magnetic Resonance Spectroscopy（^1H-MRS） in lateralization of temporal lobe epilepsy （TLE） in adolescent. Materials and Methods Twenty seven TLE patients with negative conventional Magnetic Resonance Imaging（MRI） and ten healthy adolescent controls were studied by ^1 H-MRS using single voxel short echo time with the point resolved spatial selection （PRESS） protocol. 24-hour Electroencephalogram （EEG） was also used as the standard for epileptogenic focus localization. The ratio of NAA/（ Cho ＋ Cr） , Glx and mI in lateralizing focus were analysed. Results Successful^ 1 H-MRS were achieved in 22 patients （22/27） and 10 healthy controls with stable baselines and good signal/noise ratio. Comparing to the mean values of ten healthy controls, 22 patients showed abnormal NAA/（ Cho ＋ Cr） ratios at the hippocampal area. 15 cases had correct lateralization of focus in accordance with EEG （15/22）. Conclusion Single voxel short echo ^1H-MRS with PRESS protocol are helpful in finding abnormality in lateralization of temporal epilepsy with negative MRI findings.

关 键 词：磁共振波谱成像 短回波 癫痫 脑电图 

分 类 号：R742.1[医药卫生—神经病学与精神病学]