特发性颞叶癫痫的MRI海马体积测量

Hippocampal volume measurement on MRI in idiopathic temporal lobe epilepsy

目的分析特发性颞叶癫痫的海马体积 (HCV) 变化情况, 并评价HCV测量在其诊断中的价值。方法对符合标准的3组病例, 使用3D FLASH序列扫描所得斜冠状面图像, 进行HCV测量, 并分析3组之间的差别。结果特发性颞叶癫痫 (TLE) 组低侧HCV、低侧/高侧比率明显降低, 与正常对照组及非颞叶癫痫 (NT LE) 组之间有显著统计学差别 (P=0 .0003、P=0. 0000 和 P=0 .0137、P=0 .0001)。以单侧 HCV 3SD和/或右/左侧比率±3SD为异常判断标准, 54 .5%的特发性 TLE病例、12 .9%的 NTLE病例为异常, 正常组无 1 例异常。结论HCV测量异常是癫痫的较特异的征象, 主要发生在特发性 TLE病例, 可用于特发性 TLE的辅助诊断, 但也见于少数NTLE病例。

Objective To study the hippocampal volume of idiopathic temporal lobe epilepsy(TLE),and to determine its value in diagnosis of idiopathic TLE.Methods Thirty neurologically normal peoples,31 non-temporal lobe epilepsy(NTLE)patients,11 idiopathic TLE patients were chosen to get hippocampl volume on oblique coronary MRI obtained by 3D-FLASH sequence.The absolute hippocampal volumes(HCVs)including right side,left side,lower side,higher side and HCV ratios including right side to left side,lower side to higher side were calculated in all subjects,and their differences in the three groups were compared to each other.Results The HCVs of lower side and the HCV ratios of lower side to higher side were significantly smaller than control subjects and NTLE patients(P=0.003,P=0.000 and P=0.0137,P=0.0001).Absolute HCVs were 3SD below and/or HCV ratios of lower side to higher side were 3SD below or beyond the mean of the control groups in 54.5% idiopathic TLE patients,12.9% NTLE patients,and none normal people.Conclusion Hippocampal volumetry is a useful method in the diagnosis of idiopathic TLE.Significant reduction in HCV and/or HCV ratio of smaller side to larger side are not only common in idiopathic TLE patients,but found in a small proportion of NTLE patients.