海马测量对颞叶癫痫的研究

Research on the hippocampus with MRI in patients with temporal lobe epilepsy

目的 :探讨MRI海马测量对颞叶癫痫的诊断价值。方法 :正常成人对照组 2 0例 ,测量海马体积 ;脑电图检查发现颞叶有癫痫波的患者 2 8例 ,用 1.5T超导磁共振仪检查 ,作垂直于海马长轴的倾斜冠状位 ,同时测量双侧海马。结果 :正常成人海马体积 ,右侧下限为 2 .60cm3 ,左侧下限为 2 .42cm3 。 2 8例患者中 15例未见海马萎缩 ,但其中有 5例颞叶病变 ,10例未发现异常病变 ;13例有海马萎缩 ,其中 9例单纯海马萎缩 (2例为双侧萎缩 ) ,2例为胶质瘤 ,其它 2例分别为海绵状血管瘤与囊肿。结论 :海马的萎缩是颞叶癫痫的重要原因 ,萎缩以单侧多见 ;T2 WI信号的升高反映了海马的硬化程度 ;MR的海马成像是脑外科开展癫痫外科手术治疗的不可缺少的部分。

Objective:To investigate the measurements for hippocampus with MRI in the epileptic patient.Methods:Twenty normal adults were selected as control group.The volume of the hippocampus was measured in 28 patients with epileptic waves in the temporal lobe examined with EEG.Measurement was made in the oblique coronary position perpendicular to the long axis of the temporal lobe using 1.5T magnetic resonance scanner Volumes of the bilateral hippocampi were simultaneously measured.Results:The lowest limit of the right hippocampus was 2.60 cm 3 and the lowest limit of the left side was 2.42cm 3 in the normal adults.Atrophy of the hippocampus was not found in 15 cases.5 cases,however,had lesion in the temporal lobe.Hippocampal atrophy was found in 13 cases.Of which,9 cases were simple atrophy,2 cases were bilateral atrophy.Conclusion:Atrophy of the hippocampus is the important cause of the temporal lobe epilepsy.Atrophy is mostly seen on the unilateral hippocampus.The elevation in signal intensity on T 2WI reflected the degree of sclerosis of the hippocampus.MRI is necessary for sargical treatment of the disease.