儿童颞叶癫痫的海马磁共振弥散张量成像研究  

Diffusion Tensor Imaging of Hippocampus in Children with Temporal Lobe Epilepsy

作　　者：杨皓玮[1,2] 何慧瑾[1] 帕米尔[2] 周碧婧[1] 冯晓源[1] 

机构地区：[1]复旦大学附属华山医院放射科 [2]复旦大学附属儿科医院放射科

出　　处：《中国医学计算机成像杂志》2013年第4期303-306,共4页Chinese Computed Medical Imaging

摘　　要：目的:探讨磁共振弥散张量成像(DTI)对儿童颞叶癫痫海马硬化及其定侧的诊断价值。方法:我院就诊的单侧颞叶癫痫(TLE)患儿25例纳入研究,根据常规MRI表现分成MRI阳性组和MRI阴性组;并根据年龄和性别比例选取对照组15例,行海马常规MRI扫描和横轴位DTI扫描。测量并比较病例组及对照组之间海马的平均弥散系数(MD)值和各向异性分数(FA)值。结果:MRI阳性组TLE的患侧海马MD值明显高于MRI阴性组和正常对照组,三组之间的差异具有统计学意义(P=0.013)。MRI阳性组患侧海马的FA值明显低于MRI阴性组和正常对照组,与正常对照组之间的差异具有统计学意义(P=0.036)。MRI阳性组对侧海马也发现MD值升高和FA值降低,其变化程度低于患侧,且与患侧海马间差异均具有显著性意义(P值分别为0.036,0.018)。MRI阴性组双侧海马的MD值无显著性差异,FA值具有显著性差异(P=0.001)。结论:MRI阳性组和MRI阴性组儿童颞叶癫痫,发作间期海马的DTI参数值表现不同,以MD值变化更显著。DTI对颞叶癫痫,尤其是海马硬化具有一定的定侧诊断价值。Purpose： To evaluate the application value of diffusion tensor imaging（DTI） of hippocampus in children with temporal lobe epilepsy （TLE）. Methods： Twenty-five patients with TLE, who were divided into MRI positive hippocampus （H＋） group and negative hippocampaus （H-） group, and 15 healthy controls were enrolled in this study. Conventional MRI and DTI data with 20 diffusion-gradient-direction were obtained on a 1.5 Tesla Siemens MR imaging scanner. The mean diffusivity （MD） and fractional anisotropy （FA） values of hippocampus were calculated in all paitents. Results： The MD value of the ipsilateral hippocampus in the H＋ group was much higher than that in the H- group and the control group. The difference among the three groups was with statistical significant （p--0.013）. The FA value of the ipsilateral hippocampus in the H~ group was much lower than that in the H- group and the control group. The difference between H＋ group and control group was with statistical significant （P=0.036）. The contralateral hippocampus in the H＋ group was also found the elevation of MD value and reduction of FA value, and the differences between them with the ipsilateral hippocampus were with statistical significant （P=0.036, p=0.018）. There was no significant difference of MD values between bilateral hippocampus in the H- group, but their FA values were significantly different （P=0.001）. Conclusion： Children with TLE, including H＋ group and H-group, have different DTI parameters in hippocampus. While the MD value shows much more significant changes. DTI has potential application value for lateralization of the TLE, especially in hippocampal sclerosis patients.

关 键 词：颞叶癫痫 海马 弥散张量成像 

分 类 号：R742.1[医药卫生—神经病学与精神病学]