颞叶内侧癫痫伴海马硬化患者胼胝体形态特征的MRI研究  

Morphological characteristics of the corpus callosum in patients with medial temporal lobe epilepsy with hippocampal sclerosis

作　　者：陶博 乐治军 祝菲 唐颖莹[2] 高梓洋 吴孟莲 周东[2] 吕粟[1] Tao Bo;Le Zhijun;Zhu Fei;Tang Yingying;Gao Ziyang;Wu Menglian;Zhou Dong;Lyu Su(Department of Radiology,West China Hospital of Sichuan University,Chengdu 610041,China;Department of Neurology,West China Hospital of Sichuan University,Chengdu 610041,China;Department of Clinical Research Management,West China Hospital of Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院放射科,成都610041 [2]四川大学华西医院神经内科,成都610041 [3]四川大学华西医院临床研究管理部,成都610041

出　　处：《中华放射学杂志》2025年第2期177-183,共7页Chinese Journal of Radiology

基　　金：四川大学华西医院135高端人才支持计划项目(ZYGD23003);四川大学“从0到1”创新研究项目(2023SCUH0050);四川省干部保健科研普及应用项目(川干研2024-104)。

摘　　要：目的:探讨内侧颞叶癫痫(mTLE)伴单侧海马硬化(HS)患者的胼胝体形态特征及其与海马体积、临床指标的相关性。方法:该研究为横断面研究。回顾性分析2017年6月至2023年5月在四川大学华西医院就诊并经术后病理证实的44例mTLE伴单侧HS患者和42名健康受试者的临床(发病年龄、病程、癫痫发作频率、痫性发作持续时间等)及影像资料。44例mTLE伴单侧HS患者中,左侧HS 19例,右侧HS 25例。对所有受试者进行高分辨率三维T 1WI。采用开源软件包Freesurfer测量海马体积,采用开源软件包ART根据Witelson分割范式把高分辨率T 1WI图像中的胼胝体分成7个亚区(喙部、膝部、嘴体部、前中体部、后中体部、峡部、压部),得到其胼胝体总面积、周长、长径、厚度、圆度及各亚区面积。采用独立样本t检验或单因素方差比较2组或3组间各指标的差异。采用Pearson或Spearman相关分析观察mTLE伴单侧HS患者胼胝体形态特征与海马体积及其他临床指标间的相关性。结果:与健康受试者比较,mTLE伴单侧HS患者胼胝体总面积、胼胝体圆度及胼胝体膝部、前中体部、后中体部、峡部、压部面积和厚度及嘴体部面积均显著减低(P<0.05)。mTLE伴左侧HS、mTLE伴右侧HS、健康受试者的胼胝体总面积、圆度和胼胝体膝部、嘴体部、前中体部、后中体部、压部面积和胼胝体膝部、前中体部、后中体部、峡部厚度总体差异均具有统计学意义(P<0.05),其中与健康受试者比较,mTLE伴右侧HS患者的胼胝体总面积、圆度及胼胝体膝部、嘴体部、前中体部、后中体部、压部面积及膝部、前中体部、后中体部及峡部厚度较健康受试者显著减低(P<0.05),mTLE伴左侧HS患者的胼胝体中体部和峡部厚度较健康受试者显著减低(P<0.05),其余指标两两比较差异均无统计学意义(P>0.05)。相关分析示mTLE伴单侧HS患者的部分胼胝体形态异常与其发病�Objective To explore the morphological characteristics of the corpus callosum(CC)in patients with unilateral medial temporal lobe epilepsy(mTLE)with hippocampal sclerosis(HS),and their correlation with hippocampal volume and clinical indicators.Methods This was a cross-sectional study.Clinical(age of onset,disease duration,seizure frequency,seizure duration,etc.)and imaging data of 44 patients mTLE with unilateral HS confirmed by postoperative pathology and 42 healthy controls(HCs)recruited at West China Hospital of Sichuan University from June 2017 to May 2023 were analyzed retrospectively.Among the 44 patients,19 had left-sided HS and 25 had right-sided HS.All subjects underwent high-resolution 3D T 1WI.Hippocampal volumes were obtained using FreeSurfer.ART was used to measure the morphological parameters of the CC for each participant,including total CC area,volume,perimeter,length,thickness,circularity,and the area of seven CC subregions defined by Witelson:rostrum,genu,body,anterior midbody,posterior midbody,isthmus and splenium.Differences in these metrics between two or three groups were compared using independent samples t-test or one-way ANOVA.Pearson or Spearman correlation analysis was used to observe the correlation between morphological features of the CC and hippocampal volume and other clinical indicators in patients with mTLE with unilateral HS.Results Compared with HCs,patients with mTLE with unilateral HS had significantly reduced total CC area,CC circularity,as well as the area and thickness of the genu,anterior midbody,posterior midbody,isthmus,splenium,and the area of the rostrum(P<0.05).Significant differences were observed in the total area,circularity,and subregional areas(genu,rostrum,anterior midbody,posterior midbody,splenium),as well as thickness(genu,anterior midbody,posterior midbody,isthmus)of the CC among mTLE with left-sided HS,mTLE with right-sided HS,and HCs(P<0.05).When compared to HCs,the total area of the CC,circularity and the areas of the genu,rostrum,anterior midbody,poste

关 键 词：癫痫 颞叶 磁共振成像 海马硬化 胼胝体 形态特征 

分 类 号：R74[医药卫生—神经病学与精神病学]