MRI测量颞叶癫痫患者海马体积与波谱分析

MRI Volume Measurement and Proton Spectroscopy of Hippocampal Formation in Temporal Lobe Epilepsy

目的：探讨利用磁共振图像判断海马萎缩在颞叶癫痫的意义，揭示颞叶癫痫病灶的质子磁共振波谱的变化特征。材料与方法：对７例不同病程癫痫患者进行三维快速扰相位梯度回波序列（３Ｄ－ＦＳＰＧＲ）和ＰＲＥＳＳ序列波谱采样，测量双侧海马的体积和海马区域的 ＮＡＡ／Ｃｒ、Ｃｈｏ／Ｃｒ比值，在同一患者左右侧进行对比。结果：早期颞叶癫痫患者海马萎缩、ＮＡＡ／Ｃｒ下降均不明显，Ｃｈｏ／Ｃｒ较对侧升高；发展到海马硬化阶段可以有海马萎缩、ＮＡＡ／Ｃｒ下降和 Ｃｈｏ／Ｃｒ升高；静息状态的癫痫患者有海马萎缩和ＮＡＡ／Ｃｒ下降，但是Ｃｈｏ／Ｃｒ无升高表现。结论：利用磁共振图像可以准确反映颞叶癫痫患者海马体积的变化；１Ｈ－ＭＲＳ可以反映癫痫患者海马区域的代谢变化，为癫痫的定位提供信息。

Purpose: To investigate the hippocampal atrophy in the temporal lobe epilepsy (TLE)by MR imaging and its' Proton MR Spectroscopy(1H-MRS) changes in the TLE lesion. Materisls and Methods: 7cases of TLE were examined by 3-dimensional fast spoiled gradient echo sequenc e (3D-FSPGR ) and PR ESS sequence. The hippocampal volumes and the ratios of NAA/Cr, Cho/Cr were measured and compared bilaterally. Results: The early stage of TLE showed no obvious hippocampar atrophy and NAA/Cr reduction but significant elevation of Cho/Cr, In the stage of Hippocampal sclerosis. Hippocampal atrophy, NAA/Cr reduction and CHo/Cr elevation were demonstrated, In the rest stage of seizure, Cho/Cr elevation disappeared, but hippocampal atrophy and NAA/Cr reduction still exist. Conclusions: MR Images can give accurate hippocampal volume changes in TLE; 1H-MRS can provide important metabolic information for localization in the region of hippocampal lesions.