磁共振波谱与颞叶癫痫痫样放电的相关性研究

Correlative study of ^1H-MRS and clinical seizures in patients with temporal lobe epilepsy

目的:探讨颞叶癫痫(TLE)患者氢质子磁共振波谱(1H-MRS)与癫痫发作之间的关系。方法:对45例手术证实为单侧TLE患者的单体素1H-MRS及视频脑电图(VEEG)进行回顾性分析,计算代谢产物氮-乙酰天门冬氨酸(NAA)、肌酸(Cr)、胆碱复合物(Cho)的值,分析代谢产物变化与临床癫痫发作程度的相关性。癫痫发作程度以24h内VEEG所记录的痫样放电的次数及程度来描述。结果:病变侧和对侧NAA、Cr和Cho均值分别为(52.31±12.78)ppm和(42.78±8.06)ppm、(43.36±10.43)ppm和(58.04±13.25)ppm、(40.49±10.02)ppm和(42.42±10.68)ppm,NAA值和发作间期痫样放电频率呈明显负相关(r=-0.67,P<0.05),而Cr水平与癫痫发作症状呈明显正相关(r=0.86,P<0.05)。结论:1H-MRS分析能够反映TLE的严重程度,是TLE患者术前评价的一种有价值的辅助检查方法。

Objective：To evaluate the relationship of 1H-MRS and seizure symptoms in patients with temporal lobe epilepsy（TLE）.Methods：Single voxel 1H-MRS and video electroencephalogram（VEEG）of 45 patients with unilateral TLE confirmed by surgical pathology were retrospectively analyzed.The metabolites of N-acetyl L-aspartic acid（NAA）,creatine（Cr）and choline（Cho）were calculated respectively and the relevance of metabolite levels and clinical epileptic seizures was analyzed.Severity of seizures was evaluated by provocation number of clinical seizures in 24h and frequency of interictal epileptiform discharges（IEDs）.Results：The average values of NAA,Cr and Cho were（52.31±12.78）ppm,（42.78±8.06）ppm and（43.36±10.43）ppm respectively for lesion group,and（58.04±13.25）ppm,（40.49±10.02）ppm,（42.42±10.68）ppm respectively for contralateral group.A negative correlation was found between NAA values and frequencies of IED in VEEG（r=-0.67,P〈0.05）;a positive correlation was found between Cr levels and severities of seizure symptoms（r=0.86,P〈0.05）.Conclusion：1H-MRS is able to reflect the severity of TLE and provide a significant complementary modality for evaluating TLE preoperatively.