MR扩散张量成像联合视频脑电图对颞叶癫痫的诊断价值  

Diagnostic value of MR diffusion tensor imaging combined with video electroencephalogram in temporal lobeepilepsy

作　　者：杜远敏 许康 王云凤 王剑 涂文仙 DU Yuanmin;XU Kang;WANG Yunfeng;WANG Jian;TU Wenxian(Department of Neurology,General Hospital of the Yangtze River Shipping,Wuhan 430010,China)

机构地区：[1]长江航运总医院神经内科,湖北武汉430010

出　　处：《实用放射学杂志》2022年第6期876-879,共4页Journal of Practical Radiology

基　　金：武汉市医学科研项目(WX19C23);长江航务管理局科技项目(201910019)。

摘　　要：目的 探讨MR扩散张量成像(DTI)联合视频脑电图(VEEG)对颞叶癫痫的诊断价值.方法 选取诊断明确的颞叶癫痫患者30例为研究组,同期选取与研究组年龄、性别相匹配的无明显脑部外伤史、无神经及精神病的健康志愿者30例为对照组.所有受试者均进行DTI检查,测量表观扩散系数(ADC)、部分各向异性(FA)值.对研究组进行VEEG检测.比较DTI、VEEG以及二者联合对颞叶癫痫的检出率.评估VEEG与DTI检出病灶的空间一致性.结果 研究组病灶侧ADC值显著高于对照组和研究组非病灶侧,FA值显著降低(P<0.05);研究组和对照组DTI颞叶癫痫检出率分别为83.33%和6.67%;研究组VEEG颞叶癫痫检出率为73.33%;DTI与VEEG检查对病灶定位检测一致率为71.4%.DTI联合VEEG检查对颞叶癫痫诊断敏感度为93.33%,特异性为90.00%,准确率为91.67%.结论 DTI联合VEEG检查对颞叶癫痫有较高的检出率,有利于精确定位病灶,减少颞叶癫痫的漏诊率.Objective To investigate the diagnostic value of MR diffusion tensor imaging(DTI)combined with video electroencephalogram(VEEG)in temporal lobe epilepsy.Methods Thirty patients with temporal lobe epilepsy who were diagnosed were selected as the study group,and 30 healthy volunteers who were matched with the age and gender of the study group and did not have obvious history of brain injury and neurological and psychiatric diseases were selected as the control group.All subjects were examined by DTI,the apparent diffusion coefficient(ADC)and fractional anisotropy(FA)were measured.VEEG was performed on the study group.The detection rate of DTI,VEEG and their combination in temporal lobe epilepsy was compared.The spatial consistency of VEEG and DTI in detecting epileptic lesion was evaluated.Results The ADC value of the lesion side in the study group was significantly higher than control group and the non lesion side in the study group,and the FA value was significantly lower(P<0.05);the detection rate of temporal lobe epilepsy by DTI in study group and control group was 83.33% and 6.67% respectively,and the detection rate of temporal lobe epilepsy in the study group by VEEG was 73.33%;the coincidence rate of lesion location detection by DTI and VEEG was 71.4%.The sensitivity,specificity and accuracy of DTI combined with VEEG in the diagnosis of temporal lobe epilepsy were 93.33%,90.00% and 91.67%,respectively.Conclusion DTI combined with VEEG has a high detection rate of temporal lobe epilepsy,which is beneficial to accurately locate the lesions and reduce the missed diagnosis rate of temporal lobe epilepsy.

关 键 词：磁共振成像 扩散张量成像 视频脑电图 颞叶癫痫 

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]