摘要
目的测量正常成人及癫痫病人海马结构(HF)体积,探讨其在颞叶癫痫(TLE)致痫灶定侧中的价值。材料与方法本组包括52例正常成人及89例癫痫病人,把病人分为三组:继发性癫痫48例、特发颞叶外癫痫15例、TLE26例,后者有22例为顽固性癫痫。均作垂直于海马长轴的冠状位自旋回波(SE)序列T1加权像、TurboSET2加权像,测量颞叶、HF体积和颞角、环池宽度,肉眼观察T2加权像海马信号强度改变。采用HF体积绝对值对TLE定侧。结果获取了正常成人HF体积。22例TLEHF体积缩小,其中3例为双侧性;6例HF硬化经手术、病理证实,1例体积正常且致痫灶位于HF周围者HF硬化轻,8例其他类型癫痫病人HF体积略小,TLE致痫灶定侧的敏感性为85%,特异性为87%。3例TLE病人同侧前颞叶萎缩;部分TLE病侧颞角、环池宽度增加;萎缩明显的HFT2加权像信号弥漫性增高。结论HF体积缩小、T2加权像信号弥漫性增高是HF硬化萎缩的直接征象,与病变严重程度、致痫灶在颞叶的部位有关,前颞叶萎缩和颞角、环池增宽是HF硬化的辅助征象。HF萎缩不仅是颞叶癫痫的主要原因。
Purpose To measure the hippocampal volume in normal adults and patients with epilepsy, and discuss its value in lateralization of seizure focus in temporal lobe epilepsy(TLE). Materials and methods 52 normal adults and 89 epileptic patients were studied, the latter were subdivided into 3 groups: secondary epilepsy(48 cases), primary non temporal lobe epilepsy(15 cases), and TLE(26 cases),of which 22 were intractable epilepsy. The imaging protocal for volumetry of anterior temporal lobe (ATL) and hippocampus formation(HF), and measurement of the width of temporal horn and ambient cistern included SE T 1WI and Turbo SE T 2WI with the imaging plane perpendicular to the long axis of hippocampus. The signal intensity of hippocampus was investigated on the T 2WI. The lateralization of TLE was defined by absolute volume value of HF. Results The HF volume of normal adults was acquired.22 patients with TLE had volume loss of HF, 3 of them were bilateral, the hippocampal sclerosis(HS) in 6 cases was confirmed pathologically,1 patient with normal volume of HF had the seizure focus around HF and HS was mild. 8 with other kinds of epilepsy had slight volume loss of HF. The sensitivity of lateralization of TLE was 85%. The specificity was 87%. 3 with TLE had obviously atrophy of ipsilateral ATL. In some cases with TLE, the width of temporal horn and ambient cistern was enlarged. The atrophic hippocampus with significant volume loss presented diffuse increase in signal intensity on T 2WI. Conclusion The volume loss and diffuse increase of signal intensity on T 2WI of HF were direct findings of HS which was correlated with the degree of sclerosis and the position of seizure focus in temporal lobe. The widened temporal horn, ambient cistern and atrophic ATL were supplementary findings of HS. The authors considered that hippocampal atrophy was not only the main cause of TLE, but might also be the result of seizures of other kinds of epilepsy.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
1998年第4期224-227,共4页
Chinese Journal of Radiology
关键词
癫痫
海马
数据收集
磁共振成像
体积
结构
Epilepsy, temporal lobe Hippocampus Data collection Magnetic resonance imaging