颞叶癫痫的核磁共振质子波谱与脑电的对比研究

Proton MRS vs EEG study in temporal lobe epilepsypsy

目的：评价核磁共振质子波谱（ＭＲＳ）对颞叶癫痫的诊断价值。方法：１０例症状明确的颞叶癫痫患者分别采集双侧近中颞叶脑组织的质子波谱并对Ｎ—乙酰天门冬胺酸（ＮＡＡ）、总肌酸（ＣＲ）、胆碱复合物（ＣＨＯ）进行半定量分析。所有病例均做脑电图检查。结果：所有病例均有单侧ＮＡＡ峰减低、ＡＮＮ／ＣＲ和ＮＡＡ／ＣＲ＋ＣＨＯ值的减少，其中７例ＮＡＡ减少与脑电图异常位于同一侧；２例脑电图正常而ＭＲＳ显示异常；另外１例ＮＡＡ的减少与脑电图结果不一致。结论：颞叶癫痫病人脑电图异常侧ＮＡＡ减少，ＭＲＳ可无创探测癫痫灶内神经元受损或功能异常的生化改变，进一步了解其病理基础。

Purpose: to evaluate the ability of proton MRS to detectabnorlities in the brain of human with temporal lobe epilepsy. Methods: proton MR spectroscopys were obtained in both medial region oftemporal lobe in 10 patients with well characterized temporal lobeepilepsy and the signals from N acetylaspartate (NAA)、creatine+phosphocreating (CR) and choline containing compounds (CHO) wereanalyzed. All patients were performed EEG examnation. Results: in 7patients, the reduction in NAA signals and the ratio of NAA/CR and NAA/CR+CHO were normal EEG showed abnormal MRS; one incorrectlateratization was showeed by MRS. Conclusions: NAA was regard as themark of neurol, the reduction of NAA may reflect the loss ordamage of neuronal. MRS is a uninvasive method to investigate themetabolic pathology of seisure focus in TLE and provides usefulinformation to the preoperational patiens.