伴海马硬化及占位性内侧颞叶癫痫脑灰质形态学研究  

Morphometric Study of Brain Gray Matter in Medial Temporal Lobe Epilepsy Associated with Hippocampal Sclerosis and Space-Occupying Lesion

作　　者：魏渭[1] 张志强[1] 许强[1] 谭启富[2] 黄育斌[1] 卢光明[1] 

机构地区：[1]南京大学医学院附属金陵医院(南京军区南京总医院)医学影像科,210002 [2]南京大学医学院附属金陵医院(南京军区南京总医院)神经外科,210002

出　　处：《临床放射学杂志》2015年第5期680-684,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金面上项目(编号:81271553);国家自然科学基金中外合作重大项目(编号:81020168022)

摘　　要：目的研究伴海马硬化及占位性内侧颞叶癫痫(m TLE)脑灰质形态改变的差异,并探讨不同类型m TLE脑结构损伤特征及潜在的病理生理机制。方法对30例伴海马硬化m TLE(m TLE-HS)、30例颞叶占位性m TLE患者(m TLE-OL)以及30名健康受试者进行全脑扫描,采用磁化准备快速梯度回波成像(MPRAGE)序列获得三维T1结构图像。运用代价函数对图像预处理,应用非线性映射空间变换的基于体素的形态学测量(VBM)进行分析,比较不同病因m TLE颞叶外脑灰质体积(GMV)的改变,并观察m TLE患者GMV改变与病程的相关性。结果相比于正常对照组,两组m TLE均有颞叶外的GMV改变,但变化脑区分布模式不同:m TLE-HS显示更广泛的脑灰质萎缩(P<0.01,Alpha-Sim校正)。m TLE-HS患者局部GMV与病程无明显相关性;m TLE-OL患者对侧顶下叶及患侧基底节区GMV与病程负相关。结论不同类型m TLE脑灰质形态学改变不同,提示两者存在的癫痫网络有所不同,进一步证实了m TLE-HS为一种特异性癫痫综合征。Objective To investigate the distinction of morphometric changes of brain gray matter in medial temporal lobe epilepsy （mTLE） with hippocampal sclerosis and space-occupying lesion, and to discuss their characteristics of struc- tural brain damage and potential pathological physiological mechanism. Methods A total of 30 mTLE patients with hipp- ocampal sclerosis （mTLE-HS） and 30 mTLE with space-occupying lesion （mTLE-OL） in temporal lobe were enrolled in this study; and 30 age- and sex-matched healthy subjects were collected as normal control group. Three dimensional T1 weighted magnetic images of all subjects were performed by using magnetization prepared rapid acquisition gradient-echo （MPRAGE） sequence. A cost-function modification was used for image pre-processing, the difference in extratemporal gray matter volume （GMV） changes between mTLE-HS group and mTLE-OL group was analyzed using voxel-based morphometry of nonlinear mapping space transformation. Then the correlation between GMV and epilepsy duration of TLE was evaluated. Results Compared to the control group, both mTLE-HS group and mTLE-OL group showed significant changes in extratemporal GMV, but the distribution patterns of changes in brain were different; the mTLE-HS patients presented more extensive reduction of GMV （P 〈 0.01, Alphasim corrected）. No significant correlation was found between GMV and epilepsy duration in mTLE-HS patients; in mTLE-OL patients the GMV in contralateral inferior parietal lobe and in ipsilatera1 basic ganglia had a negative correlation with epilepsy duration. Conclusion Different types of mTLE have different morphometric changes of brain gray matter, suggesting that their epilepsy network are different, which further proves that mTLE-HS is a specific epileptic syndrome.

关 键 词：颞叶癫痫 海马硬化 体素 形态学 

分 类 号：R742.1[医药卫生—神经病学与精神病学]