磁共振波谱分析与液体衰减反转恢复成像在诊断海马硬化中的作用分析

An analysis of magnetic resonance spectroscopy and fluid attenuated inversion recovery on diagnosis of hippocampal sclerosis

目的通过对23例颞叶癫痫病人的磁共振波谱分析(magneticresonancespectroscopy,MRS)与液体衰减反转恢复(fluidattenuatedinversionrecovery,FLAIR)序列成像结果进行分析,探讨其在诊断海马硬化中的作用与意义。方法经手术治疗的23例颞叶癫痫病人,术中皮层电极及深部电极、术后病理检查结果证实为外侧型癫痫6例,海马硬化型17例,分析其术前磁共振T1、T2、FLAIR序列、MRS检查结果。结果6例颞叶外侧型癫痫海马区T1、T2、FLAIR序列、MRS检查均无异常,17例海马硬化型中6例T1、T2显示异常,7例FLAIR序列高信号,16例MRS显示氮-乙酰天冬氨酸(N-acetylaspantate,NAA)峰明显下降,其中1例显示双侧NAA峰下降。结论MRS可在MRI出现改变之前发现海马硬化,其诊断海马硬化灵敏且特异性高,FLAIR序列优于T2加权相,MRS与FLAIR序列是海马硬化术前诊断一个可靠的方法。

Objective To explore the diagnosis value of magnetic resonance spectroscopy (MRS) and fluid attenuated inversion recovery (FLAIR) on hippocampal sclerosis by analysis of the both examination result on 23 temporal epilepsy patients.Methods 23 temporal epilepsy patients consist of 6 lateral temporal epilepsy and 17 hippocampal sclerosis approved by cortical Electroencephalogram (EEG) and deep electrodes EEG in operation and post operational pathological diagnosis.The examination results of T_1 weighted,T_2 weighted,FLAIR sequence,MRS were analyzed.Results 6 lateral temporal epilepsy had normal expression on T_1 weighted,T_2 weighted,FLAIR sequence,MRS.6 of 17 Hippocampal sclerosis demonstrated abnormal on T_1 weighted and T_2 weighted,7 of 17 Showed hyperintense on FLAIR sequence,16 of 17 Showed decreased on peak NAA including one case decreased on both sides.Conclusion MRS could diagnose hippocampal sclerosis before the change in MRI with sensitively and specially.FLAIR sequence was better than T_2 weighted.MRS and FLAIR sequence is a reliable method on diagnosis of hippocampal sclerosis before operation.