磁共振波谱对原发性癫痫患者海马病变的诊断价值  

Diagnostic value of magnetic resonance proton spectrum examination on hippocampus lesions in patients with primary epilepsy

作　　者：武强[1] 王鹰[2] 游曼洁[1] 廖光昊[1] 濮捷[1] 程鹤[1] 

机构地区：[1]广州军区武汉总医院神经内科,430070 [2]广州军区武汉总医院放射科,430070

出　　处：《临床神经病学杂志》2012年第5期325-327,共3页Journal of Clinical Neurology

摘　　要：目的探讨磁共振波谱(MRS)对原发性癫痫患者海马病变的诊断价值。方法对38例原发性癫痫患者(癫痫组)和30例健康志愿者(正常对照组)进行EEG、MRI和MRS检查。采用MRS检测双侧海马N-乙酰天门冬氨酸(NAA)、肌酸复合物(Cr)和胆碱复合物(Cho)的水平。结果正常对照组EEG、MRI、MRS检查均无异常。癫痫组EEG检查发现痫样放电30例(78.9%);MRI检查发现海马异常15例(39.5%),其中双侧异常10例、单侧异常5例;MRS检查发现海马异常35例(92.1%),其中双侧异常30例、单侧异常5例。癫痫组病侧海马Cho/Cr和Cho/NAA显著高于对侧海马及正常对照组(均P<0.001),NAA/(Cho+Cr)显著低于对侧海马及正常对照组(均P<0.001)。癫痫组病侧海马头部的NAA/(Cho+Cr)明显低于体部及尾部(均P<0.001)。结论 MRS可提高原发性癫痫患者海马病变的检出率,且可显示海马的生化改变,对原发性癫痫具有很高的诊断价值。Objective To explore the diagnostic value of magnetic resonance proton spectrum （MRS） on hippocampus lesions in patients with primary epilepsy. Methods Thirty eight patients with primary epilepsy （epilepsy group） and 30 healthy volunteers （normal control group） were examined by EEG, MRI and MRS. The metabolic products of N-aeetylaspartate （ NAA ） , creatine （ Cr ） and choline （ Cho ） were quantitatively analyzed through MRS on bilateral hippocampus. Results There was no abnormal in normal control group by EEG, MRI and MRS. In epilepsy group, there were 30 cases （78.9%） found epileptiform discharges by EEG; there were 15 cases （39.5%） found abnormal in hippoeampus by MRI, including 10 cases of bilateral abnormality and 5 cases of unilateral abnormality ; there were 35 cases （92.1% ） found abnormal in hippoeampus by MRS, including 30 cases of bilateral abnormality and 5 cases of unilateral abnormality. The values of Cho/Cr and Cho/NAA of the abnormal side hippocampus in the epilepsy group were significantly higher than those in the normal side of hippoeampus and the normal control group （ all P 〈0. 001 ） , and the value of NAA/（ Cho ＋ Cr） of the abnormal side hippoeampus in the epilepsy group was significantly lower than that in the normal side of hippocampus and the normal control group （ all P 〈 0. 001 ）. The value of NAA/（ Cho ＋ Cr） of the head of hippocampus was significantly lower than that in the body and the tail of hippocampus in the abnormal side （ all P 〈 0. 001 ）. Conclusion MRS can increase the positive rate of hippocampus lesions in patients with primary epilepsy, and can show the biochemical changes of the hippoeampus, which has a high diagnosis value on primary epilepsy.

关 键 词：原发性癫痫 磁共振波谱 海马 

分 类 号：R742.1[医药卫生—神经病学与精神病学]