穹窿和乳头体立体定向MRI解剖学研究

Stereotactic anatomical study of the fornix and mammillary body in Chinese people by MRI

目的探讨生理和病理状态下人脑穹窿和乳头体的MRI解剖学,为诊断相关疾病提供影像学基础。方法应用3.0MR机在标准立体定向空间内,对29例健康中国人和15例颞叶内侧癫痫患者行全脑扫描。测量穹窿和乳头体体积以及乳头体坐标。结果健康中国人穹窿体积左侧、右侧分别为(0.531±0.150)cm3和(0.541±0.143)cm3,乳头体左侧坐标为X=(-2.18±0.26)mm、Y=(3.76±0.49)mm、Z=(-7.48±0.73)mm,右侧坐标为X=(2.27±0.34)mm、Y=(3.73±0.67)mm、Z=(-7.48±0.98)mm;乳头体长度为(4.53±0.54)mm、宽度为(4.25±0.41)mm、高度为(4.09±0.74)mm;健康中国人乳头体左侧、右侧体积分别为(54.77±7.99)mm3、(54.10±9.83)mm3。同性别健康中国人的左右侧穹窿、乳头体体积无明显区别(P>0.05),乳头体的径线及坐标也无明显区别(P>0.05);不同性别间,同侧穹窿和乳头体体积、乳头体的径线及坐标均无明显区别(P>0.05)。颞叶内侧癫痫患者的颞叶硬化侧穹窿、乳头体体积[分别为(0.403±0.110)cm3和(27.80±8.06)mm3]较非硬化侧[分别为(0.526±0.174)cm3和(51.91±8.06)mm3]明显缩小(P<0.05)。结论不同状态下,穹窿和乳头体MRI结构会发生相应变化,这些特点可为诊断相关疾病提供参考。

Objective To get the anatomical information of the fornix and mammillary body （MB） of brains in healthy Chinese and to explore morphologic change in the fornix and MB in the patients with mesial temporal lobe epilepsy （MTLE） in order to provide basic data and standard imaging for diagnosis of MTLE. Methods The series of brain MR images including T1 and T2 images were acquired in 29 Chinese healthy volunteers and 15 patients with MTLE, in whom in the standard stereotactic space the volumes of the fornix and MB in all the subjects, and three dimeusions （length, width and height） and coordinates of MB centres in 29 Chinese healthy velunteers were determined by TriPlanar MedViewer software. Results The volumes of the left and right fornixes were （0.531 ±0.150）cm3 and （0.541 ± 0. 143）cm3 respectively, and the coordinates of the left and right MB centres were X=（-2.18±0.26）mm, Y=（3.76±0.49）mm and Z=（-7.48± 0.73）mm, and X=（2.27±0.34）mm, Y=（3.73±0.67）mm, and Z=（-7.48±0.98）mm respectively in 29 health Chinese subjects. The volume [（0.403 ±0.110）cm3] of the fornixes in the side with temporal sclerosis was significantly smaller than that [（0.526±0.174）cm3] in the side with healthy temporal lobes in I5 patients with MTLE （P〈0.05）. The length, width and height of the MB were （4.53±0.54）mm, （4.25±0.41） mm and （4.09±0.74）mm respectively. The volumes of the left and right MB were （54.77±7.99）mm3, （54.10±9.83）mm3 respectively in 29 health Chinese subjects. The volume [（27.80±8.06）mm3] of the MB in the side with temporal sclerosis was significantly smaller than that [（51.91 ± 8.06）ram3] in the side with healthy temporal lobe in 15 patients with MTLE （P〈0.01）. There are insignificant differences in the fornix volumes and MB volumes, central coordinates and three dimessions （length, width and height） between the left and right sides in the same gender Chinese and between male and female in healthy Chinese people （P〉0.05）. Conclusion The volumes of the fornixes and MB in the side with the temporal sclerosis may shrink compared to the side with healthy temporal lobe in the patients with MTLE and health people.