MRI与MR扩散成像在颞叶癫痫中临床应用价值  

MRI and diffusion-weighted imaging in temporal lobe epilepsy

作　　者：李豪刚[1] 郭学军[2] 刘海辉[1] 李兴荣[1] 刘丽娟[1] 张玉忠[1] 曹火乃[1] 

机构地区：[1]南方医科大学附属深圳市龙华人民医院(深圳市龙华新区人民医院放射科),广东518109 [2]北京大学深圳医院放射科,广东518036

出　　处：《影像诊断与介入放射学》2013年第2期94-98,共5页Diagnostic Imaging & Interventional Radiology

基　　金：深圳市宝安区科技计划社会公益项目;(20110572)

摘　　要：目的探讨MRI与MR扩散成像在颞叶癫痫中临床应用价值。方法选取30例癫痫患者行MRI常规序列(含垂直于海马长轴斜冠状位FLAIR序列)及扩散加权成像(DWI)检查,分析海马大小形态信号影像表现,并与脑电图、手术病理对照。结果 30例患者经手术病理证实均为单侧海马硬化,右侧1 8例,左侧12例,脑电图表现提示相应颞叶慢波或嵴波,MRI表现患侧海马体积缩小26例,4例海马双侧体积无明显变化,T_2WI序列高信号11例,FLAIR序列高信号16例,DWI序列异常高信号4例,ADC值升高26例,1例同时有DI高信号和ADC值升高;海马头部浅沟消失26例,患侧颞叶及邻近白质萎缩10例,患侧颞角扩大12例,环池增宽10例。结论综合运用MRI常规序列,FLAIR颞叶斜冠状位序列,DWI和测定海马体积、ADC定量分析中,对癫痫诊疗可提供比较准确定侧、定位、定性诊断。Objective To assess the value of conventional MRI and diffusion MR imaging in temporal lobe epilepsy. Methods Thirty patients underwent conventional MRI including oblique coronal FLAIR-weighted sequence perpendicular to the long axis of the hippocampus and diffusion-weighted MR imaging （DWI） for assessment of the hippocampal size and shape in correlation with EEG and histology. Results Of 30 patients with unilateral hippocampal sclerosis （18 right-sided, 12 left-sided ）, EEG showed slow wave or crest wave in the ipsilateral temporal lobes. There was smaller ipsilateral hippocampal volume in 26 patients and no significant difference in 4 patients. The ipsilateral hippocampi were hyperintense on T2WI （11）, FLAIR-weighted images （16）, and DWI （4）as well as high ADC （26）. Other MRI findings included loss of the groove between the head and neck of the ipsilateral hippocampi （26）, atrophy of the ipsilateral temporal lobe and adjacent white matter （10）, dilatation of the temporal horn of the ipsilateral lateral ventricle （12）, widening of the ambient cistern （10）. Conclusions The combination of oblique coronal FLAIR-weighted sequence, DWI, ADC and hippocampal volume determination can provide more accurate diagnosis of hippocampal sclerosis in temporal lobe epilepsy.

关 键 词：颞叶 癫痫 海马硬化 磁共振成像 扩散加权成橡 表观扩散系数 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742.1[医药卫生—诊断学]