颞叶癫痫MR海马容积测量

MRI based volumetry of HF in patients with temporal lobe epilepsy

目的：测量正常成人及颞叶癫痫病人海马体积，讨论其在颞叶癫痫（ＴＬＥ）致痫灶定侧中价值。方法：本组包括５２例正常成人和２６例颞叶癫痫病人，后者有２２例为顽固性癫痫。均作垂直于海马轴的冠状位ＳＥ序列Ｔ１加权像、ＴｕｒｂｏＳＥＴ２加权像，测量颞叶、海马体积和颞角、环池宽度，肉眼观察Ｔ２加权像海马信号强度改变。采用海马体积绝对值对ＴＬＥ定侧。结果：获取了正常成人海马体积。２２例ＴＬＥ海马体积缩小，其中３例为双侧性；６例海马硬化经手术、病理证实，１例体积正常且致痫灶位于海马周围者海马硬化轻。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；萎缩明显的海马Ｔ２加权像信号弥漫性增高。结论：海马体积缩小、Ｔ２加权像信号弥漫性增高是海马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。

Objective: to measure the hippocampal volume in normal adults and in patients with temporal lobe epilepsy (TLE) and discuss its value in lateralization of seizure focus in TLE. Material and methods: 52 normal adults and 26 patients with TLE were studied, 22 of 26 with TLE were intractable epilepsy. The imaging protocal for volumetry of anterior temporal lobe (ATL) and HF, and measurement of the width of temporal born and ambien cistern included SE T1WI and Turbo SE T2WI whose imaging plane were perpendicular to long axis of hippocampus. The signal intensity of hippocampus was investigated on the T2WI. 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 6vcases were confirmed pathologically, 1 patient with normal volume of HF bad the seizure focus around HF and the HS was mild. 3 with TLE had obviously atrophy of ATL ipslateral to atrophic HF. In some cases with TLE, the width of temporal horn and ambien cistern was larger than that of other groups. The hippocampus with decreased volume significantly presented increased signal intensity diffusely on T2WI Conclusion: The volume loss and increased signal intensity diffusely on T2WI of HF sere direct findings of HS which was correlated with the degree of sclerosis and the position of seizure focus in temporal lobe. The widen temporal born, amibien cisten and atrophic ATL were supplementary findings of HS.