基于MEGA-PRESS序列的海马GABA+及Glx定量在颞叶癫痫的研究  

Quantification of hippocampal GABA+and Glx based on MEGA-PRESS sequence in temporal lobe epilepsy

作　　者：王旭聪 杨文蕊 陈兵[1] WANG Xucong;YANG Wenrui;CHEN Bing(Department of Radiology,General Hospital of Ningxia Medical University,Yinchuan 750003,China)

机构地区：[1]宁夏医科大学总医院放射科,宁夏银川750003

出　　处：《实用放射学杂志》2025年第3期376-380,共5页Journal of Practical Radiology

摘　　要：目的 探讨颞叶癫痫(TLE)患者双侧海马区γ-氨基丁酸复合物(GABA+)、谷氨酸及谷氨酰胺复合物(Glx)水平变化,并分析与临床间的潜在相关性.方法 采用定量Meshcher-Garwood点分辨光谱(MEGA-PRESS)序列测定23例TLE患者(TLE组)和20例健康志愿者(对照组)海马区GABA+及Glx水平,比较受试者双侧海马区代谢物水平的差异性;同时比较对照组与TLE患侧亚组、TLE健侧亚组之间海马区代谢物的差异性.利用Spearman相关系数评估海马区差异性代谢物水平与临床的相关性.结果 对照组双侧海马区2种代谢物水平呈左右对称分布;TLE组患侧海马区GABA+水平显著低于对照组双侧海马区,TLE组患侧海马区Glx水平与对照组未见明显差异;TLE组患侧海马区GABA+水平显著低于健侧[(1.65±0.85)i.u.vs(1.86±0.58)i.u.;(1.68±0.67)i.u.vs(1.80±0.81)i.u.];认知障碍(CI)TLE亚组患侧海马区GABA+水平显著低于认知正常TLE亚组,2个亚组间Glx含量未见明显差异(P>0.05).CI TLE亚组GABA+水平与病程及发作频率呈明显负相关(r=-0.90,P<0.05;r=-0.91,P<0.05).结论 海马区CI GABA+水平改变标志着TLE的发生及疾病进展,并与CI之间有密切的相关性.Objective To explore the levels ofγ-aminobutyric acid complex(GABA+),glutamate and glutamine(Glx)in the bilateral hippocampal region of patients with temporal lobe epilepsy(TLE),and to analyze the potential clinical correlation.Methods The levels of GABA+and Glx in the hippocampal region of 23 TLE patients(TLE group)and 20 healthy volunteers(control group)were measured by quantitative Meshcher-Garwood point resolved spectroscopy(MEGA-PRESS)sequence.The differences of metabolite levels in bilateral hippocampal region were compared.At the same time,the differences of metabolites in hippocampal region between control group,TLE affected subgroup and TLE unaffected subgroup were compared.Spearman correlation coefficient was used to evaluate the correlation between hippocampal region metabolite levels and clinical.Results The levels of two metabolites in bilateral hippocampal region of the control group were symmetrical distribution.The GABA+level in the affected hippocampal region of the TLE group was significantly lower than that in the bilateral hippocampal region of the control group,and the Glx level in the affected hippocampal region of the TLE group was not significantly different from that of the control group.The level of GABA+in the affected hippocampal region of the TLE group was significantly lower than that of the unaffected[(1.65±0.85)i.u.vs(1.86±0.58)i.u.;(1.68±0.67)i.u.vs(1.80±0.81)i.u.];The level of GABA+in the affected hippocampal region of the TLE subgroup with cognitive impairment(CI)was significantly lower than that of the TLE subgroup with normal cognition,and there was no significant difference in Glx content between the two subgroups(P>0.05).The level of GABA+in the TLE subgroup with CI was negatively correlated with the course of disease and attack frequency(r=-0.90,P<0.05;r=-0.91,P<0.05).Conclusion The change of GABA+level in hippocampal region is a marker of TLE occurrence and disease progression,and is closely related to CI.

关 键 词：颞叶癫痫 Meshcher-Garwood点分辨光谱 海马硬化 Γ-氨基丁酸 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R742[医药卫生—临床医学]