儿童颞叶癫痫磁共振弥散张量成像的初步研究  

Preliminary Study of Diffusion Tensor Imaging in Children with Temporal Lobe Epilepsy

作　　者：李志勇[1] 方佃刚[1] 干芸根[1] 孟宪磊[1] 曹卫国[1] 罗益镇[1] 陈黎[2] 

机构地区：[1]深圳市儿童医院放射科,广东深圳518038 [2]深圳市儿童医院神经内科,广东深圳518026

出　　处：《吉林医学》2017年第9期1611-1613,共3页Jilin Medical Journal

基　　金：深圳市科创委基金资助项目[项目编号:JCYJ20150403100317077]

摘　　要：目的:探讨儿童颞叶癫痫(TLE)患者的弥散张量成像(DTI)参数变化特点,评价DTI在TLE病灶定侧诊断中的价值。方法:对临床诊断的22例TLE患者和20名健康志愿者行常规MRI和DTI检查,比较病例组与对照组之间海马的平均弥散系数(ADC)值和各向异性分数(FA)值是否存在差异。结果:22例TLE患者中,10例表现为单侧海马体积缩小,其中5例患侧海马FLAIR信号较对侧升高。对照组双侧海马ADC值、FA值无显著性差异(P>0.05)。TLE患者发作间期患侧海马、对侧及对照组ADC值分别为(0.821±0.045)×10^(-3)mm^2/s、(0.768±0.029)×10^(-3)mm^2/s、(0.729±0.025)×10-3mm^2/s,患侧海马ADC值高于对侧海马和对照组,且对侧海马ADC值也高于对照组(P<0.05)。TLE患者发作间期患侧海马、对侧及对照组FA值分别为(0.177±0.025)、(0.213±0.023)、(0.229±0.015),患侧海马FA值明显低于对侧海马和对照组(P<0.05),但对侧海马FA值和对照组无显著性差异(P>0.05)。结论:DTI检查可以反映TLE患者的海马弥散变化,ADC值升高、FA值降低是TLE病灶定侧诊断的有用指标。DTI对儿童颞叶癫痫具有一定的定侧诊断价值。Objective To study the application value of diffusion tensor imaging（ DTI） in children with temporal lobe epilepsy（ TLE）. Method Conventional magnetic resonance imaging（ MRI） and DTI were performed in 22 patients with TLE and 20 healthy volunteers. The apparent diffusion coefficient（ ADC） and fractional anisotropy（ FA） values of hippocampus were calculated and processed respectively. Results 10 out of 22 TLE cases showed hippocampal volume loss and in 5 cases the signal intensity of the hippocampus in the ipsilateral side of the lesion in FLAIR imaging was higher than the contra lateral side. There was no statistically significant difference in the ADC and FA in the control subjects（ P 〉 0. 05）. The ADC of the hippocampus in the ipsilateral side of the lesion,the contra lateral side and the control group were respectively（ 0. 821 ± 0. 045） × 10-3mm2/s,（ 0. 768 ± 0. 029） × 10-3mm2/s and（ 0. 729 ± 0. 025） × 10-3mm2/s. The ADC of the hippocampus in the ipsilateral side was higher than that in other groups,and the ADC of the hippocampus in the contra lateral side was higher than that in the control group（ P 〈 0. 05）. The FA of the hippocampus in the ipsilateral side of the lesion,the contra lateral side and the control group were respectively（ 0. 177 ± 0. 025）,（ 0. 213 ± 0. 023） and（ 0. 229 ± 0. 015）. The FA of the hippocampus in the ipsilateral side was lower than that in other groups（ P 〈 0. 05）,but there was no statistically significant difference between the contra lateral side and the control group（ P 〉 0. 05）. Conclusion DTI could reveal diffusion changes in the hippocampus with increased ADC and decreased FA,which is a valuable technique in lateralizing the lesion with TLE in children.

关 键 词：颞叶癫痫 海马硬化 儿童 弥散张量成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]