海马硬化致颞叶癫癎的SPECT与MRI研究  

SPECT and MRI study in patients with temporal lobe epilepsy caused by hippocampal sclerosis

作　　者：关乐[1] 卢洁[1] 曹燕翔[2] 张人玲[1] 梁志刚[1] 李坤成[2] 

机构地区：[1]首都医科大学宣武医院医学影像学部核医学科,北京100053 [2]首都医科大学宣武医院医学影像学部放射科,北京100053

出　　处：《中国现代神经疾病杂志》2015年第11期870-874,共5页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：北京市卫生系统高层次卫生技术人才培养计划(项目编号:2011-3-094)~~

摘　　要：目的探讨SPECT脑血流灌注显像结合MRI测量海马体积对海马硬化致颞叶癫癎患者致灶的定位价值。方法采用99Tcm-双半胱乙酯(99Tcm-ECD)SPECT脑血流灌注显像对双侧海马血流灌注进行定性和半定量分析,MRI测量双侧海马体积,分析海马硬化致颞叶癫癎(颞叶癫癎组)患者患侧海马相对脑血流量与相应区域海马体积的相关性。结果颞叶癫癎组患者患侧海马相对脑血流量[(46.04±7.94)ml/(100 g·min)]低于对侧[(54.76±9.62)ml/(100 g·min);t=-2.966,P=0.005]和正常对照者[(64.87±7.28)ml/(100 g·min);t=-4.824,P=0.000],且海马体积[(1.69±0.39)cm3]小于对侧[(2.68±0.41)cm3;t=-7.410,P=0.000]和正常对照者[(3.50±0.39)cm3;t=-16.340,P=0.000]。海马硬化致颞叶癫癎患者患侧海马相对脑血流量与相应区域海马体积呈正相关(r=0.394,P=0.017)。结论海马硬化致颞叶癫癎患者患侧海马相对脑血流量降低、海马体积缩小,二者呈正相关。SPECT脑血流灌注显像结合MRI测量海马体积,可以作为致灶切除术前准确定位的参考依据。Objective To analyze the changes of hippocampus blood perfusion and hippocampal volume in patients with temporal lobe epilepsy（TLE） caused by hippocampal sclerosis（HS） using singlephoton emission-computed tomography（SPECT） and MRI,so as to explore the effect on localization of epileptogenic focus in TLE patients.Methods Eighteen TLE patients and 3 healthy controls underwent^（99）Tc^m-ethyl cysteinate dimer（^（99）Tc^m-ECD） SPECT.Eighteen TLE patients and 21 healthy controls were performed MRI.The relative cerebral blood flow（rCBF） and hippocampal volume were calculated and compared between 2 groups.The correlation between rCBF in ipsilateral hippocampus and hippocampal volume of TLE patients was analyzed.Results SPECT showed rCBF in ipsilateral hippocampus[（46.04 ±7.94） ml/（100 g.min）]was significantly decreased compared with contralateral hippocampus in TLE patients[（54.76± 9.62）ml/（100g.min）;t=-2.966,P=0.005]and bilateral hippocampus in healthy controls[（64.87±7.28） ml/（100g.min）;t=-4.824,P=0.000].The volume of ipsilateral hippocampus[（1.69±0.39） cm^3]was significantly smaller than that of contralateral hippocampus in TLE patients[（2.68±0.41） cm3;t=-7.410,P=0.000]and bilateral hippocampus in healthy controls[（3.50±0.39） cm3;t=- 16.340,P=0.000].The rCBF of ipsilateral hippocampus had positive correlation with the volume of corresponding hippocampus in TLE patients（r =0.394,P =0.017）.Conclusions Both rCBF and the volume of ipsilateral hippocampus were reduced in patients with TLE caused by HS,and there was positive correlation between the two.It was helpful for preoperative localization of epileptogenic focus to combine SPECT with MRI.

关 键 词：癫癎 颞叶 海马 体层摄影术 发射型计算机 单光子 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R817.4[医药卫生—诊断学] R742.1[医药卫生—临床医学]