颞叶癫痫MR扩散加权成像的初步研究

Preliminary Study of MR-diffusion Weighted Imaging in Temporal Lobe Epilepsy

目的应用MR扩散加权成像技术(DWI)分析颞叶癫痫(TLE)患者的海马扩散运动变化规律,初步探讨表观扩散系数(ADC)对TLE定侧诊断的价值。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DWI检查,定量测量双侧海马的ADC值并统计,同时比较TLE患者与健康志愿者海马ADC值的不对称指数(AIADC)。结果健康志愿者双侧海马ADC值无显著性差异。TLE患者患侧海马、对侧海马及正常人海马ADC值分别为:(0.9357±0.0773)mm2/s、(0.8572±0.0464)mm2/s、(0.8092±0.0303)mm2/s,患侧海马ADC值显著高于对侧海马及正常志愿者(P=0.000)。TLE患者及正常人海马的AIADC分别为:(8.5778±7.1720)%、(1.5389±1.4659)%,患者AIADC显著高于正常人(P=0.000)。结论DWI检查可以反映TLE患者的海马扩散变化,ADC值升高、AIADC增大是TLE病灶定侧诊断的有用指标。

Objective To evaluate diffusion weighted imaging （DWI） findings in temporal lobe epilepsy （TLE） and investigate the role of apparent diffusion coefficient （ADC） in lateralizing the seizure lesions. Materials and Methods Conventional magnetic resonance imaging （MRI） and DWI were performed in 42 patients with TLE and 32 healthy volunteers. The ADC value of bilateral hippocampi was measured and processed respectively. Asymmetry index of ADC （ AIADC ） in bilateral hippocampi was compared. Results There was no statistically significant difference in the ADC between bilateral hippocampi of the control subjects （ P 〉 0.05 ）. The mean ADC of the hippocampus in the ipsilateral side of the lesion, the contralateral side and bilateral side in the control group was （0.9357±0.0773）mm^2/s, （0.8572 ± 0.0464） mm^2/s, （0. 8092± 0.0303 ） mm^2/s, respectively with the mean ADC of the hippocampus in the ipsilateral side higher than that in other groups （P = 0. 000 ）. The AIADc in TLE patients and control subjects was （8. 5778 ±7. 1720 ）% , （1. 5389 ± 1. 4659）%, respectively with the AIADC in TLE patients higher than that in the control group. Conclusion DWI could reveal diffusion changes in the hippocampus with increased ADC and AIADC as a useful index in lateralizing the lesion in patients with TLE.