海马磁共振波谱分析在颞叶癫痫症中的价值

Value of hippocampal magnetic resonance spectroscopy in temporal lobe epilepsy dis-

目的探讨海马氢质子磁共振波谱分析（1H—MRS）在颞叶癫痫症中的应用价值。方法采用PhihpsAchieva1．5T双梯度磁共振扫描仪，对38例颞叶癫痫患者和20例健康志愿者行颅脑MRI和海马’H—MRs检查，观察NAA、Cr、Cho浓度和NAA／（Cho＋Cr）、NAA／Cr和NAA／Cho值。分别对癫痫患者病灶侧与正常侧，病灶侧与正常对照组海马的NAA／（Cho＋Cr）、NAA^r和NAA／Cho值进行t检验，分析两者之间差异有无显著性。结果癫痫患者组癫痫侧、正常侧和对照组海马的NAA／（Cho＋Cr）值分别为（O．424-0．06）、（0．67±0．09）、（O．72±0．07），癫痫组癫痫侧与正常侧、对照组比较差异有显著性（尸〈0．05），而正常侧与对照组比较差异无显著性（尸〉0．05）。以NAA／fCho＋c0来检出癫痫，灵敏度曲线呈现低一高一低的变化，在0．60时，灵敏度最高。结论-H—MRS不仅能早期诊断海马硬化，而且可进一步提高术前癫痫灶定位的准确性。

Objective To study the application value of hippocampus proton magnetic reso- nance spectroscopy QH-MRS） in temporal lobe epilepsy. Methods With Philips Achieva 1.5T dual gradient MR scanner, 38 patients with temporal lobe epilepsy and 20 healthy volunteers were underwent brain MRI and hippocampal ~H-MRS examination, observation indicators included the concentration of NAA, Cr, Cho and the value of NAA/（Cho＋Cr）, NAMCr and NAA/Cho. The NAA/（Cho＋Cr）, NAA/Cr and NAA/Cho values in hippocampus of epilepsy side of epilepsy group, the normal side of epilepsy group, and the normal control group had a t test, analyzing the statistical difference between the two groups.Results The NAA/（Cho＋Cr） values in hippocampal of the epilepsy side of epileptic patients, the normal side of epileptic patients and the control group were （0,42＋0.06）, （0.67＋0.09）, （0.72＋0.07）, respectively, there was significant difference between the epilepsy side and the normal side of epileptic patients, and between the epilepsy side of epileptic patients and the control group（_P〈0.05）, but no significant difference between the normal side of epileptic patients and the control group（P〉0.05）. Using NAA/（Cho＋Cr） to detect epilepsy, the sensitivity curve showed low--＊high---~low changes, the highest sensitivity appeared in 0.60.Conclusion ~H-MRS not only has early diagnosis to hippocampal sclerosis, but also improves the accuracy of preoperative localization of epileptic focus,