3.0TMR质子波谱成像诊断难治性颞叶癫痫海马硬化的价值  

Value of 3.0T MR spectroscopy imaging to the diagnosis of refractory hippocampal sclerosis in patients with temporal lobe epilepsy

作　　者：曾文兵[1] 秦媛[1] 汪明全[1] 杨染[1] 高才良[1] 温云[1] 

机构地区：[1]重庆三峡中心医院放射科,重庆404100

出　　处：《中华实用诊断与治疗杂志》2014年第8期806-807,809,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：重庆市卫生局医学科研计划项目(2010-2-364)

摘　　要：目的探讨3.0T MR质子波谱成像(proton magnetic resonance spectroscopy,1 H-MRS)在难治性颞叶癫痫海马硬化早期诊断中的应用价值。方法 64例难治性颞叶癫痫海马硬化患者(观察组),行1 H-MRS检查,分析海马N-乙酰基天门冬氨酸(N-acetylaspartate,NAA)、胆碱复合物(choline,Cho)与肌酸复合物(creatine-phosphocreatine,Cr)波峰特点及NAA/(Cho+Cr)比值,与21例体检健康者(对照组)进行比较。结果观察组1 H-MRS检查发现左侧海马异常10例,右侧异常7例,双侧异常47例;与对照组比较,观察组海马异常侧1 H-MRS图像主要表现为NAA波峰降低,Cr和Cho波峰增高;观察组海马单侧异常者患侧NAA/(Cho+Cr)值(0.484±0.145)低于健侧(0.846±0.120)(P<0.05),双侧异常者主要异常侧NAA/(Cho+Cr)值(0.382±0.115)低于对侧(0.563±0.167)(P<0.05);对照组双侧NAA/(Cho+Cr)均值为0.843±0.122,高于观察组海马单侧异常者患侧、双侧异常者双侧(P<0.05)。结论 1 H-MRS可反映神经元的丢失和/或胶质细胞增生,在难治性颞叶癫痫海马硬化早期诊断中有重要价值。Objective To explore the value of proton magnetic resonance spectroscopy（1 H-MRS）to the early diagnosis of refractory sclerotic hippocampus in patients with temporal lobe epilepsy（TLE）.Methods Sixty-four TLE patients with hippocampal sclerosis（observation group）received 1 H-MRS to analyze the features of N-acetylaspartate（NAA）,choline（Cho）and creatine-phosphocreatine（Cr）and to calculate NAA/（Cho＋Cr）ratio,and were compared with 21 healthy volunteers（control group）.Results In observation group,1 H-MRS showed left lateral hippocampus abnormality in 10 patients,right lateral hippocampus abnormality in 7,and bilateral abnormality in 47.1 H-MRS showed lower NAA wave peak and higher Cr and Cho wave peak in observation group.NAA/（Cho＋Cr）ratio was 0.484±0.145 in abnormal hippocampus,significantly lower than that in normal hippocampus（0.846±0.120）（P〈0.05）,and was 0.382±0.115 in abnormal hippocampus,significantly lower than that in normal hippocampus（0.563±0.167）in observation group（P〈0.05）.The NAA/（Cho＋Cr）was 0.843±0.122 in both sides of hippocampus in control group,higher than that in patients with hippocampus abnormality（P〈0.05）.Conclusion 1 H-MRS can reflect the loss of neurons and/or gliocyte proliferation,which plays an important role in the early treatment of clinical temporal lobe epilepsy.

关 键 词：颞叶癫痫 海马硬化 磁共振质子波谱成像 

分 类 号：R742.1[医药卫生—神经病学与精神病学]