双重病理所致颞叶癫痫边缘系统MRI影像学表现  

The MRI changes of limbic system in temporal lobe epilepsy caused by double pathology

作　　者：成丽娜[1,2] 汪文胜 郭圣文 赖春任[3] 赵地 沈君[1] CHENG Li-na;WANG Wen-sheng;GUO Sheng-wen(Sun Yat-sen Memorial Hospital,Sun Yat-senUniuersity,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院,广州510120 [2]广东三九脑科医院影像中心,广州510510 [3]华南理工大学材料科学与工程学院,广州510006

出　　处：《放射学实践》2018年第11期1118-1123,共6页Radiologic Practice

基　　金：广东省医学科学技术研究基金(A2015507)

摘　　要：目的:总结双重病理(DP)所致颞叶癫痫(TLE)的边缘系统MRI影像学改变及特征。方法:对DP所致TLE 36例(左侧组20例,右侧组16例)与正常对照组(36例)进行多模态MR成像,分析两组边缘系统所在脑区T1WI灰质体积、指数化表观扩散系数(eADC)、脑血流量(CBF)差异,并进行统计学分析。结果:结构像及功能像均发现左侧、右侧TLE组边缘系统脑区与对照组差异具有统计学意义(FDR校正,P≤0.001),功能成像显示更广范围脑区分布,检出最明显异常为病侧海马及海马旁回、眶额皮质,其次为杏仁核、扣带回、内侧额上回,最后为额叶直回、丘脑,右侧组可累及对侧部分边缘系统脑区。结论:左、右侧DP所致TLE边缘系统损伤具有差异性,右侧组异常范围大于左侧。多模态MRI对边缘系统损伤评估具有重要价值。Objective:The aim of this study was to summarize the MRI imaging changes and characteristics of limbic system in temporal lobe epilepsy(TLE)caused by double pathology(DP).Methods:Parameters of multimodal MR imaging,grey matter volume,exponential apparent diffusion coefficient(eADC)and cerebral blood flow(CBF)value were compared.The statistical parametric maps were acquired between 36 patients with TLE caused by DP(left group:20 cases,right group:16 cases)and control group(36 healthy subjects).Results:In the brain region of limbic system of left and right TLE group,there were significant differences(FDR correction,P=0.001)compared with control group,which was shown more widely in functional imaging than that in structural imaging.The most sensitive areas for positive detection were found in laterality(epileptogenic)hippocampus,parahippocampalgyrus,and orbitofrontal cortex;followed by amygdala,cingulate gyrus,and superior medial frontal gyrus;and finally,gyrus rectus and thalamus.The contralateral abnormality was also found in the cases of right TLE group.Conclusion:The damage of limbic system in right and left TLE caused by DP is different,and the range of abnormality of the right group is greater than that in the left group.Multimodal MRI can provide an important value for the damage assessment of limbic system.

关 键 词：癫痫 颞叶 边缘系统 磁共振成像 

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