海马头部海马趾的丢失对海马硬化的诊断价值

The evaluation of loss of digitations in the hippocampal head in the diagnosis of hippocampal sclerosis

目的探讨海马头部海马趾的丢失对海马硬化的MR诊断价值。方法50例手术病理证实为海马硬化的难治性颞叶癫痫患者和30例健康志愿者为研究对象。采用GE1.5TSignaHorizonLX超导型磁共振机,行垂直于海马长轴的倾斜冠状面T1W、T2W成像。回顾性分析MR检查资料,重点评价海马头部海马趾的情况,分为海马趾完全丢失、海马趾部分丢失和海马趾清晰存在三种情况。结果30例健康志愿者的双侧海马趾清晰存在,50例海马硬化患者中22例病侧海马趾完全丢失,22例病侧海马趾部分丢失,1例双侧海马趾完全丢失,另5例海马趾清晰存在。海马趾丢失对诊断海马硬化的敏感性达到90%,特异性为100%。将对海马趾的评价与原海马硬化MRI诊断标准结合起来,诊断敏感性可提高至94%。结论海马头部海马趾的丢失对海马硬化具有重要诊断价值,可作为海马硬化MR诊断的主要征象之一。

Objective To evaluate the significance of the loss of visualization of digitations in the hippocampal head in the MR diagnosis of hippocampal sclerosis（HS）. Methods 50 intractable temporal lobe epilepsy patients with histologically confirmed hippocampal sclerosis and 30 healthy volunteers were involved in the study. GE 1.5 T Signa Horizon LX MRI scanner was used to obtain oblique coronal T1W and T2W images perpendicular to the long axis of the hippocampus. We analysed the MRI findings retrospectively, and evaluated the visibility of digitations in the hippocampal head, principally based on the three classifications： complete loss of digitations, partial loss of digitations and sharp visibility of digitations. Results In the control group, digitations were sharply visible in all 30 patients. Among the 50 HS patients, 22 had complete loss of digitations on the ipsilateral side, 22 partial loss of digitations on the ipsilateral side, 1 complete loss of digitations on both sides, and the rest 5 sharply visible digitations. The sensitivity of loss of digitations for the diagnosis of HS was 90%, and the specificity was 100%. With combination of the evaluation of loss of digitations and the previous diagnosis criteria of HS, the sensitivity was elevated to 94%. Conclusion The loss of digitations in the hippocampal head, which is of great significance for the diagnosis of HS, can be used as a major diagnostic criterion to establish the MR diagnosis of HS.