应用磁共振及弥散张量成像技术对强直-阵挛性癫痫持续状态患者脑损害的临床研究

The clinical brain damage study in patients with tonic-clonic status epilepticus with magnetic resonance and diffusion tensor imaging technologies

目的应用磁共振及弥散张量成像技术(DTI)研究全身强直阵挛性癫痫发作(GTCS)持续状态停止后,患者颅内的继发损害及动态变化。方法 17例患者GTCS持续状态停止后24h内,进行头部MRI及DTI扫描,之后1w复查。结果 (1)MRI检查,11例有颅内病灶,复查后6例病灶缩小或消失;(2)DTI检查,双侧海马区FA值降低P<0.05,5例复查,双侧海马区FA值较前升高P<0.05。结论 (1)GTCS持续状态患者以双侧基底节继发性损害为主;(2)DTI能发现GTCS持续状态患者海马区微结构损伤;(3)GTCS持续状态控制后1w脑继发性损伤可能逐步恢复或少数持续存在。

Objective To estimate the application of magnetic resonance and diffusion tensor imaging （DTI） in generalized tonie-clonic seizures （GTCS） with intracranial secondary damage and dynamic changes after continuous seizures. Methods 17 patients were cranial MRI and DTI scaned within 24 hours after the cessation of the continued seizure status of GTCS, the patients were reviewed 1 week later. Results （ 1 ） MRI, 11 patients with intracranial lesions and six lesions shrink or disappear 1 week later. （2） The bilateral hippocampus District FA values decrease with DTI scans, P 〈 0.05, the bilateral hippocampus FA values increased over the previous in five reviewed cases,P 〈 0. 05. Conclusion （ 1 ）Secondary damage was found in bilateral basal ganglia of patients with GTCS persistent state. （ 2 ） The DTI can find hippocampus micro-structural damage in patients with GTCS continued status. （3）Brain injury may be gradually restored or minority persist after the cessation of GTCS continued state one week later.