MRI与1H-MRS在颞叶癫痫病灶定位中的诊断价值  

Diagnostic value of MRI and 1H-MRS in the location of temporal lobe epilepsy

作　　者：刘艳丽[1] 冯敏[1] 肖益群[1] Liu Yanli;Feng Min;Xiao Yiqun(Second People's Hospital of Zhengzhou,Zhengzhou 450000,Henan,China)

机构地区：[1]郑州市第二人民医院,河南郑州450000

出　　处：《临床心身疾病杂志》2019年第5期121-124,共4页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨常规磁共振成像与氢质子磁共振波谱在颞叶癫痫病灶定位中的诊断价值.方法将48例颞叶癫痫患者设为观察组,40例健康志愿者设为对照组,均行常规磁共振成像与氢质子磁共振波谱扫描,对检查结果进行对比分析.结果观察组常规磁共振成像检查颞叶癫痫病灶准确定位率(60.4%)显著低于氢质子磁共振波谱检查(91.7%)(P<0.01);氢质子磁共振波谱检查观察组患侧海马部位氮-乙酰天门冬氨酸/(胆碱+肌酸)、氮-乙酰天门冬氨酸/肌酸、氮-乙酰天门冬氨酸/胆碱比值显著低于观察组对侧及对照组,观察组患侧和对侧杏仁核部位氮-乙酰天门冬氨酸/(胆碱+肌酸)、氮-乙酰天门冬氨酸/肌酸、氮-乙酰天门冬氨酸/胆碱比值显著低于对照组,差异均有统计学意义(P<0.01).结论与常规磁共振成像检查相比,氢质子磁共振波谱检查对颞叶癫痫病灶准确定位率高,优于磁共振成像检查,可作为颞叶癫痫患者术前定位的辅助检查在临床推广应用.Objective To investigate the diagnostic value of conventional magnetic resonance imaging and hydrogen proton magnetic resonance spectroscopy in the localization of temporal lobe epilepsy. Methods 48 patients with temporal lobe epilepsy were enrolled in the observation group, and 40 healthy volunteers were set as the control group. All were given routine magnetic resonance imaging and hydrogen proton magnetic resonance spectroscopy. The results were compared and analyzed. Results The accurate localiza-tion rate of temporal lobe epilepsy (60.4%) in the observation group was significantly lower than that of proton magnetic resonance spectroscopy (91. 7%)(P<0.01). Hydrogen proton magnetic resonance spec-troscopy was used to observe the hippocampus of the affected group. The ratios of nitrogen-acetylaspar- tate/(choline + creatine), nitrogen-acetylaspartate/creatine, and nitrogen-acetylaspartate/choline were sig-nificantly lower than those in the observation group and the control group. The ratio of nitrogen-acetylas- partate/(choline+creatine), nitrogen-acetylaspartate/creatine, and nitrogen-acetylaspartate/choline in the affected side and contralateral amygdala was significantly lower than that in the control group, the differ- ence was statistically significant (P<0. 01). Conclusions Compared with conventional magnetic resonance imaging, hydrogen proton magnetic resonance spectroscopy has a high accurate localization rate for tempo-ral lobe epilepsy, which is superior to MRI. It can be used as an auxiliary examination for preoperative lo-calization of temporal lobe epilepsy.

关 键 词：颞叶癫痫 致痫病灶 磁共振成像 氢质子磁共振波谱 精确定位 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]