MR扩散张量成像对颞叶癫痫定侧诊断价值的初步研究

Preliminary Study of MR Diffusion Tensor Imaging in Lateralizing Temporal Lobe Epilepsy

目的探讨颞叶癫痫(TLE)患者的扩散张量成像(DTI)参数变化特点,并评价DTI在TLE病灶定侧诊断中的价值。资料与方法对临床诊断的42例发作间期TLE患者和32名健康志愿者行常规MRI和DTI检查,定量测量海马平均扩散系数(DCavg)、部分各向异性(FA)、1-容积比(1-VR)和相对各向异性(RA)值,应用接受者操作特征曲线(ROC)分析DTI参数测量法、参数差值(D)法和不对称指数(AI)法对TLE定侧诊断的敏感性和特异性。结果发作间期TLE患侧海马DTI参数变化特点DCavg升高,FA、1-VR、RA减低。参数测量法DCavg、FA、1-VR和RA对TLE定侧诊断的敏感性和特异性分别为88.1%,87.5%;92.9%,93.7%;90.5%,93.7%;88.1%,93.7%。差值法D的敏感性和特异性分别为85.7%,87.5%。不对称指数法AIDCavg、AI1-VR和AIRA的敏感性和特异性分别为85.7%,87.5%;76.2%,59.4%;66.7%,62.5%。结论DTI是TLE病灶定侧诊断的有效方法。DTI参数测量法对TLE的定侧诊断价值优于参数差值法和不对称指数法。

Objective To investigate the diffusion tensor characteristics of hippocampi in patients with temporal lobe epilepsy （TLE） and to evaluate the diagnostic value of diffusion tensor imaging （DTI） in lateralization of the epileptogenic focus. Materials and Methods 42 interictal patients of TLE and 32 healthy volunteers received conventional MR and DTI scanning. The DCavg, FA, 1 VR and RA of bilateral hippocampi were measured respectively. Measurements of DTI parameters were compared with their difference（D）, asymmetry index（AI） for the correct lateralization diagnosis by receiver operating characteristic （ROC） analysis. Results The patients with TLE had significantly increased DCavg and decreased FA, 1 VR, RA in ipsilateral hippocampi. Measurement of DTI parameters： the sensitivity and specificity for DCavg, FA, 1 VR and RA were 88.1%. 87.5% ; 92.9%, 93.7%; 90.5%, 93.7%; 88. 1%, 93.7%, Difference of DTI parameters： the sensitivity and specificity for DDCavg were 85.7% , 87.5% . Asymmetry index of DTI parameters： the sensitivity and specificity for AIDCavg, AI1-VR and AIRA were 85.7%. 87.5% ; 76.2%, 59.4% ; 66.7%, 62.5%, Conclusion DTI is a valuable technique, and the lateralization diagnostic value of DTI measurements is better than that of difference and asymmetry index.