成人颞叶癫痫发作间期CT灌注成像的变化

Interictal CT perfusion changes in adult temporal lobe epilepsy

目的探讨成人颞叶癫痫发作间期单侧和双侧痫性放电CT灌注成像的变化。方法将21例颞叶癫痫患者根据视频脑电图监测分为单侧痫性放电组11例、双侧痫性放电组10例,两组患者均在发作间期行CT灌注成像检查,计算每例患者双侧颞叶脑血流量(cerebral blood flow,CBF)、脑血容量(cerebral blood volume,CBV)、平均通过时间(mean transit ti me,MTT)的灌注参数,并比较每组患者颞叶CBF、CBV、MTT以及两组的CBF、CBV、MTT不对称指数(asymmetry index,AI)。结果21例患者头颅CT平扫均无异常,每组患者发作间期双侧颞叶CBF、CBV、MTT差异无统计学意义(P>0.05),两组患者CBF不对称指数差异有统计学意义(t=2.269,P=0.035),CBV和MTT不对称指数差异无统计学意义(P>0.05),在单侧痫性放电组中,痫性放电侧颞叶脑血流量较对侧有所减低,但比较差异无统计学意义(t=-2.093,P=0.063)。结论颞叶癫痫CT灌注成像显示颞叶区发作间期单侧痫性放电较双侧痫性放电脑血流量不对称。

Objective To explore changes of CT Perfusion imaging in adult temporal lobe epilepsy（TLE） of unilateral and bilateral interictal discharges. Methods Twenty--one adult patients with temporal lobe epilepsy including eleven TLE of unilateral interictal discharges and ten TLE of bilateral interictal discharges according to video-electroencephalography（VEEG） underwent CT perfusion imaging. Perfusion parameters compassing Cerebral blood flow（CBF）,Cerebral blood volume（CBV） and Mean transit time（MTT） in bilateral temporal lobes were measured for each patient and their asymmetry index（AI） values were calculated. CBF, CBV and MTT were compared between bilateral temporal lobe in each group. AI values of CBF,CBV and MTT were compared between two groups. Results The results of CT scan indicated no abnormal findings from cranial structures of each patient. There were no significant differences in terms of CBF,CBV and MTT between bilateral temporal lobe in each group（P〉0.05）. There was significant difference in terms of their AI values of CBF between two groups （t=2. 269,P=0. 035）. However, no significant differences were found in terms of AI values of CBV and MTT （P〉0.05）. In unilateral interictal discharges patients＇ group, the perfusion tended to be lower in the unilateral temporal lobe restricted to the area of interictal electroencephalography（EEG） abnormality than in the contralateral temporal lobe. The CBF of unilateral temporal lobe, however, was not significantly different from that of contralateral temporal lobe （t=-2. 093,P=0. 063）. Conclusion CT perfusion indicates that cerebral blood flow in temporal lobe is more asymmetric in unilateral TLE than in bilateral TLE.