3D-ASL对MRI平扫阴性癫痫患儿的诊断价值  

Diagnostic value of 3D-ASL in children with MRI-negative epilepsy

作　　者：冀鹏 李红 闫松 王威 周彦汝 朱晨迪 张岚[2] JI Peng;LI Hong;YAN Song;WANG Wei;ZHOU Yanru;ZHU Chendi;ZHANG Lan(Zhumadian Central Hospital,Zhumadian 463000,China;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]驻马店市中心医院,河南驻马店463000 [2]河南中医药大学第一附属医院,河南郑州450000

出　　处：《中国实用神经疾病杂志》2025年第4期453-457,共5页Chinese Journal of Practical Nervous Diseases

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

摘　　要：目的探讨磁共振动脉自旋标记(ASL)技术对MRI平扫阴性癫痫患儿的诊断价值。方法纳入60例常规MRI平扫未见异常的发作间期癫痫患儿,收集并观察ASL图像,将ASL灌注与临床及视频脑电图(VEEG)定位癫痫灶结果进行一致性检验,并分析ASL异常灌注的影响因素。结果60例患儿中54例(90.00%)为癫痫局灶性发作,6例(10.00%)为全身性发作。ASL存在灌注异常42例(70.00%),38例(63.33%)为高灌注,4例(6.67%)为低灌注;28例(66.67%)ASL定位与定位癫痫灶完全一致,9例(21.43%)部分一致。ASL灌注改变与发作1 d行ASL扫描及VEEG局灶性癫痫样放电显著相关(P<0.05),在癫痫发作后的1 d内进行ASL扫描是唯一因素,其与灌注图像定位及临床上确认的癫痫病灶位置具有高度一致性(P<0.05)。结论ASL可用于监测MRI平扫无异常的癫痫患儿发作时和发作后的脑灌注变化,并有效定位癫痫灶。Objective To investigate the diagnostic value of magnetic resonance arterial spin labelling(ASL)technique on children with MRI scan-negative epilepsy.Methods Sixty children with interictal epilepsy who did not have abnormalities on routine MRI plain scanning were included,and ASL images were collected and observed to test the consistency of ASL perfusion with clinical and video electroencephalogram(VEEG)results of locating epileptic foci and to analyze the factors influencing the abnormal perfusion of ASL.Results Out of 60 children,54(90.00%)had focal seizures and 6(10.00%)had generalised seizures.Perfusion abnormality was present in ASL in 42(70.00%)cases,hyperperfusion in 38(63.33%)cases,hypoperfusion in 4(6.67%)cases,and 28(66.67%)cases ASL localisation was completely consistent with localised epileptic foci,and 9(21.43%)cases were partially consistent.ASL perfusion changes were significantly correlated with ASL scan,focal seizure and VEEG focal epileptoid discharge on the first day of seizure(P<0.05).ASL scanning within one day after seizure was the only factor,and it was highly consistent with perfusion image location and clinically confirmed epileptic focus location(P<0.05).Conclusion ASL can be used to monitor cerebral perfusion changes during and after seizures in children with epilepsy who have no abnormalities on MRI plains and to effectively localise epileptic foci.

关 键 词：癫痫 动脉自旋标记 磁共振成像 MRI平扫阴性 视频脑电图 脑灌注 发作间期 儿童 

分 类 号：R742.1[医药卫生—神经病学与精神病学]