MRI多序列扫描诊断原发性颞叶癫痫的价值  

Value of MRI Multi-sequence Scanning in the Diagnosis of Primary Temporal Lobe Epilepsy

作　　者：闫松 冀鹏 王威 李红 YAN Song;JI Peng;WANG Wei;LI Hong(Department of Magnetic Resonance,Zhumadian Central Hospital,Zhumadian 463000,Henan Province,China)

机构地区：[1]驻马店市中心医院磁共振科,河南驻马店463000

出　　处：《中国CT和MRI杂志》2024年第5期21-24,共4页Chinese Journal of CT and MRI

基　　金：2023年度河南省重点研发与推广专项项目(232102310256)。

摘　　要：目的探究磁共振成像(MRI)多序列扫描诊断原发性颞叶癫痫(TLE)的价值。方法选取2022年1月至2023年8月在驻马店市中心医院收治的原发性TLE患者50例作为观察组,同期选取健康志愿者50例为对照组,均进行MRI多序列扫描。检测两组感兴趣区(ROI)的表观扩散系数(ADC)、部分各向异性(FA)值、脑血流量(CBF)值、N-乙酰天冬氨酸/肌酸比值(NAA/Cr)、胆碱/肌酸比值(Cho/Cr),分析各参数及联合诊断原发性TLE的临床价值。结果观察组ADC值高于对照组(P<0.05),FA值、NAA/Cr值均低于对照组(P<0.05);观察组的右海马头、左海马头、右杏仁核、左杏仁核的CBF值及总体均值高于对照组(P<0.05);两组Cho/Cr比较差异无统计学意义(P>0.05);ADC值约登指数最大时对应截断值0.96×10^(-3)mm^(2)/s,AUC为0.700,敏感度为74.00%、特异度为78.00%;FA值约登指数最大时对应截断值0.30,AUC为0.671,敏感度为86.00%、特异度为78.00%;CBF总体均值约登指数最大时对应截断值56.02 mL/100g/min,AUC为0.769,敏感度为84.00%、特异度为82.00%;NAA/Cr值约登指数最大时对应截断值1.74,AUC为0.717,敏感度为86.00%、特异度为68.00%;四者联合诊断内侧颞叶癫痫(mTLE)的价值最高,AUC为0.811,敏感度为94.00%、特异度为64.00%。结论将ADC、FA、CBF、NAA/Cr四项指标联合检测,比单一使用其中任意一项指标对mTLE的诊断具有更高的准确性,临床价值较高,值得推广。Objective To explore the value of magnetic resonance imaging(MRI)multi-sequence scanning in diagnosing primary temporal lobe epilepsy(TLE).Methods 50 patients with primary TLE admitted to Zhumadian Central Hospital from January 2022 to Aguest 2023 were selected as observation group,and 50 healthy volunteers during the same period were included in control group,and the above subjects underwent MRI multi-sequence scanning.The regions of interest(ROI)of the apparent diffusion coefficient(ADC),fractional anisotropy(FA),cerebral blood flow(CBF),N-acetylaspartate/creatine ratio(NAA/Cr)and choline/creatine ratio(Cho/Cr)were detected in the two groups,and the clinical value of various parameters and their combination in the diagnosis of primary TLE was analyzed.Results The ADC value in observation group was higher than that in control group(P<0.05)while the FA value and NAA/Cr value were lower than those in control group(P<0.05).The CBF values of right hippocampus,left hippocampus,right amygdala and left amygdala and overall mean value in observation group were higher than those in control group(P<0.05).There was no statistical significance in Cho/Cr between the two groups(P>0.05).When the Youden index of ADC value was the largest,the corresponding cutoff value,AUC,sensitivity and specificity were 0.96×10^(-3)mm^(2)/s,0.700,74.00%and 78.00%.When the Youden index of FA value was the largest,the cutoff value,AUC,sensitivity and specificity were 0.30,0.671,86.00%and 78.00%.When the Youden index of overall mean value of CBF was the largest,the corresponding cutoff value was 56.02 mL/100g/min and the AUC,sensitivity and specificity were 0.769,84.00%and 82.00%.When the Youden index of NAA/Cr value was the largest,the cutoff value,AUC,sensitivity and specificity were 1.74,0.717,86.00%and 68.00%.The combination of the four had the highest value in the diagnosis of medial temporal lobe epilepsy(mTLE),with AUC of 0.811,sensitivity of 94.00%and specificity of 64.00%.Conclusion The combined detection with ADC,FA,CBF and NAA/Cr has

关 键 词：磁共振成像 弥散加权成像 弥散张量成像 磁共振波谱学序列 表观扩散系数 脑血流量 

分 类 号：R445.2[医药卫生—影像医学与核医学]