局灶性皮质发育不良患者的磁共振波谱分析与临床相关性研究  

Analysis of magnetic resonance spectroscopy of focal cortical dysplasia and its clinical cor- relational study

作　　者：冯占辉[1] 叶兰[2] 蔡登华[3] 晏勇[4] 

机构地区：[1]贵阳医学院附属医院神经内科,贵州贵阳550004 [2]贵阳医学院机能教研室,贵州贵阳550004 [3]贵阳医学院附属医院影像科,贵州贵阳550004 [4]重庆医科大学附属第一医院神经内科

出　　处：《癫痫与神经电生理学杂志》2014年第6期330-334,共5页Journal of Epileptology and Electroneurophysiology(China)

基　　金：贵州省科学技术基金（黔科合J字[2012]2061号）

摘　　要：目的：应用多体索氢质子磁共振波谱（MRS）研究局灶性皮质发育不良（FCD）患者脑代谢特点，并进一步探讨癎性发作的机制。方法：收集来自贵阳医学院附属医院和重庆医科大学临床学院神经科门诊及住院明确诊断的20例大脑FCD伴有癎性发作患者和20名健康受试者进行多体素MRS扫描，测量患者病灶区、病灶比邻区和远离病灶区皮质氮一乙酰门冬氨酸（NAA）与肌酸（Cr）的比值（NAA／Cr），并与对照组受试者相对应皮质区NAA／Cr值比较。结果：FCD患者病灶区、病灶比邻区较对照组皮质区NAA／Cr比值显著降低（P〈0．01），远侧病灶区皮质区与对照组皮质区NAA／Cr比值之间比较差异无统计学意义（P〉0．05）；病灶区皮质NAA／Cr比值与临床癎性发作次数之间未见相关性。结论：多体索MRS可无创观察FCD患者脑代谢改变，为手术治疗FCD伴有难治性癫癎患者提供了一个重要的参考指标。Objective：To investigat metabolite concentrational alternationinrestigat of patients with focal cortical dysplasia（FCD） through magnetic resonance spectroscopy（MRS） and discuss the mecha- nism of epileptic seizures. Methods：Twenty patients with FCD accomqanied with epileptic seizures in the Affiliated Hospital of Guiyang Medical University and Chongqing Medical University and twenty healthy controls were collected as subjects. All of them were examined by MRS. The relative signal intensity of N-acetylaspartate/creatine （NAA/Cr） of 20 patients wlth FCD were measured in the lesion, prelesional region and in the region remote from the visible lesion. The data from them were compared with those from 20 normal subjects in similar brain regions. Results：FCD was characterized by significantly lower ratios of NAA and Cr in lesions and prelesional regions than in the normal regions of the controls （P 〈0.01）. The NAA and Cr ratios of the regions remote from the visible lesion of FCD were not signifi- cant compared with those of the controls （P〉0.05）. There were no correlation between NAA/Cr in le- sion and seizure frenquency. Conclusion：Mutivoxel 1H-MRS provides a/new approach for FCD at a mo- lecular metabolite level. It can be considered a very important indicator for surgical management of pa- tients with FCD and refractory epilepsy.

关 键 词：局灶性皮质发育不良(FCD) 癫癎 磁共振波谱(MRS) 

分 类 号：R742[医药卫生—神经病学与精神病学] R445[医药卫生—临床医学]