无形态学改变的儿童颞叶癫痫3.0 T磁共振2D-CSI1H-MRS应用  

Application of 3.0 T MRI 2D-CSI 1H-MRS in children with temporal lobe epilepsy without morphological changes

作　　者：朱凯 曾立红 赵香莲 张晓凡 王志伟 刘鑫春 郝明珠 ZHU Kai;ZENG Lihong;ZHAO Xianglian;ZHANG Xiaofan;WANG Zhiwei;LIU Xinchun;HAO Mingzhu(Harbin Children's Hospital,Harbin 150010,China)

机构地区：[1]哈尔滨市儿童医院,哈尔滨150010

出　　处：《磁共振成像》2020年第12期1097-1103,共7页Chinese Journal of Magnetic Resonance Imaging

基　　金：黑龙江省卫生计生委科研课题(编号:2017-232)。

摘　　要：目的探讨二维化学位移磁共振多体素氢谱(two-dimensional chemical shift magnetic resonance imaging of hydrogen proton spectroscopy,2D-CSI 1H-MRS)在无形态学改变儿童颞叶癫痫(temporal lobe epilepsy,TLE)患儿海马微观变化的价值。材料与方法回顾性分析36例患儿和20例健康对照组颞叶海马的波谱数据,分别观察性别、年龄与分布之间的关系;分析观察组单侧、双侧与对照组及观察组单侧的患侧与健侧海马磁共振波谱(MR spectroscopy,MRS)各代谢物信息比较。结果 36例患儿中,男性及发生左侧颞叶的患儿多,但性别及发病部位分布比较差异无明显统计学意义(χ^2=1.67,P>0.05);观察组双侧男性发病年龄较女性小(F=12.25,P=0.015);与对照组比较,观察组单侧及双侧N-乙酰天门冬氨酸(N-aectylaspartate,NAA)/肌酸(creatine,Cr)、NAA/胆碱(choline,Cho)、NAA/(Cho+Cr)降低(F=12.22、35.786、6.712;P<0.001),Cho/Cr升高(F=14.712,P<0.001),差异均具有统计学意义(P<0.05);观察组单侧的患侧与健侧比较NAA降低、Cho升高(P=0.034、0.016),差异均具有统计学意义(P<0.05)。结论 2D-CSI 1H-MRS检查发现颞叶微观的异常,细胞分子水平的变化,因此是一种很有前途的评估儿童TLE的工具。Objective:To explore the value of two-dimensional chemical shift magnetic resonance imaging of hydrogen proton spectroscopy(2 D-CSI 1 H-MRS)in the micro changes of hippocampus.Materials and Methods:The spectral data of temporal lobe hippocampus in 36 cases of children and 20 cases of healthy control group were retrospectively analyzed to observe the relationship between gender,age and distribution,and to analyze the metabolic information of MRS in unilateral,bilateral and control groups of observation group and unilateral and healthy side of observation group.Results:There were 36 cases with male and left temporal lobe,but there was no significant difference in gender and location distribution(χ^2=1.67,P>0.05);the age of onset of bilateral males in the observation group was younger than that of females(F=12.25,P=0.015).NAA/Cr,NAA/Cho,NAA/(Cho+Cr)in the observation group were significantly lower than those in the control group(F=12.22,35.786,6.712;P<0.001),Cho/Cr increased in unilateral group(F=14.712,P<0.001),the differences were statistically significant(P<0.05);compared with the uninjured side,NAA decreased and Cho increased in the observation group(P=0.034,0.016),and the differences were statistically significant(P<0.05).Conclusions:2 D-CSI 1 H-MRS examination showed that there were microscopic abnormalities and changes in cellular and molecular levels in temporal lobe.Therefore,it is a promising tool for the evaluation of TLE in children.

关 键 词：磁共振成像 二维化学位移磁共振多体素氢谱 形态学改变 颞叶癫痫 儿童 

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]