基于TBSS方法评价青壮年内侧颞叶癫痫患者脑白质扩散张量的变化  

Evaluation of Changes in Cerebral White Matter Diffusion Tensor in Young Adults with Medial Temporal Lobe Epilepsy Based on TBSS Method

作　　者：封莉 付丽媛 肖慧 许尚文 陈自谦 FENG Li;FU Liyuan;XIAO Hui;XU Shangwen;CHEN Ziqian(Department of Radiology,Dongfang Hospital of Xiamen University,Fuzhou Fujian 350025,China;Department of Radiology,The 900th Hospital of Joint Logistic Support Force,Fuzhou Fujian 350025,China)

机构地区：[1]厦门大学附属东方医院放射诊断科,福建福州350025 [2]联勤保障部队第900医院放射诊断科,福建福州350025

出　　处：《中国医疗设备》2021年第7期22-28,共7页China Medical Devices

基　　金：国家重点研发计划(2016YFC0103103);福建省自然科学基金项目(2019J01524,2020J011135)。

摘　　要：目的采用基于纤维束示踪空间统计分析(Tract-Based Spatial Statistics,TBSS)方法分析青壮年内侧颞叶癫痫(Medial Temporal Lobe Epilepsy,MTLE)患者脑白质扩散张量的变化,探讨其脑白质功能改变的研究。方法选取24例青壮年MTLE患者(左侧12例,右侧12例)以及12例健康对照组作为研究对象,对每位受试者采用西门子3.0 T超导磁共振扫描仪采集DTI影像数据,运用TBSS方法比较不同脑区的各向异性分数(Fraction Anisotropy,FA)值、平均弥散率(Mean Diffusivity,MD)值、轴向扩散率(Axial Diffusivity,AD)值及径向扩散率(Radial Diffusivity,RD)值的差异。结果青壮年MTLE患者较正常组的FA值明显降低(P<0.05),MD、RD及AD值明显升高(P<0.05),有差异性的脑区主要有:胼胝体、上纵束、下纵束、钩束、扣带束、丘脑前辐射束、额枕下束、皮质脊髓束等。左侧MTLE患者表现为双侧脑区改变,并以左侧脑区改变为主,左侧钩束在4个值中均有改变;右侧MTLE患者病变主要集中在右侧并伴有部分双侧脑区改变,其中MD、AD值病变范围全部为右侧脑区,右侧上纵束、下纵束及钩束在4个参数值中均有改变。结论青壮年MTLE患者可产生一定程度脑白质结构损害,左侧MTLE患者白质纤维束损伤范围较右侧更为广泛,双侧MTLE患者以同侧脑区联络纤维受损为主。Objective To investigate the changes of cerebral white matter diffusion tensor in young adult patients with medial temporal lobe epilepsy(MTLE)based on the method of TBSS.Methods Twenty-four young adult with MTLE(12 on the left and 12 on the right)and 12 healthy controls were selected as the research subjects.DTI image data were collected by Siemens 3.0 T MR scanner for each subject,and the TBSS method was used to compare the fraction anisotropy(FA)value,mean diffusivity(MD)value,axial-diffusivity(AD)values and radial diffusivity(RD)value.Results Young adult MTLE patients showed significantly lower FA values(P<0.05)and significantly higher MD,RD and AD values than the normal group(P<0.05).The main brain regions with differences are:the corpus callosum,superior longitudinal fasciculus,inferior longitudinal fasciculus,unciform fasciculus,cingulum,anterior thalamic radiation fasciculus,inferior frontal suboccipital fasciculus,corticospinal tract.Patients with left-sided MTLE exhibited bilateral brain changes with a predominance of left-sided brain area and left unciform fasciculus alterations in all four values;while the right young adults MTLE were mainly concentrated on the right side with some bilateral brain changes,in which the lesion range of MD and AD values were all in the right brain region,and the right upper longitudinal fasciculus,lower longitudinal tract and unciform fasciculus were all changed in the four parameter values.Conclusion Young adult with MTLE can develop a certain degree of structural damage to the white matter of the brain,and the extent of damage to the white matter fibers fasciculus is more extensive in left-sided MTLE patients than in the right,while the bilateral MTLE patients have mostly ipsilateral brain region contact fiber damaged.

关 键 词：内侧颞叶癫痫 磁共振成像 扩散张量成像 纤维束示踪空间统计分析 

分 类 号：R445.2[医药卫生—影像医学与核医学]