功能磁共振在惊厥性癫痫持续状态患者脑损害中的评估价值

The value of functional magnetic resonance imaging in brain damage in patients with convulsive status epilepticus

目的:探讨功能磁共振在惊厥性癫痫持续状态(CSE)患者脑损害中的评估价值。方法:将神经内科2015年5月至2017年5月收治的CSE患者19例作为CSE组,选择同期20例健康人群作为对照组,均采用磁共振波谱(MRS)及弥散张量成像(DTI)检查,并采用韦氏记忆量表及蒙特利尔认知评估量表(MOCA)评价两组人群的记忆商值(MQ)及MOCA总分。结果:CSE组病变区、病变周边区的NAA/Cr值均显著低于对照组(P<0.05);CSE组病变区、病变周边区Cho/Cr值显著高于对照组(P<O.05);CSE组患者双侧海马、杏仁核、丘脑背内侧核的翻转角(FA)均显著低于对照组(P<0.001);CSE组的MQ及MOCA得分均显著低于对照组(P<0.001);MQ、MOCA与病变区、病变周边区的NAA/Cr,双侧海马、杏仁核及丘脑背内侧核的FA值呈显著的正相关性(P<O.05);与病变区、病变周边区的Cho/Cr呈显著的负相关性(P<O.05)。结论:CSE患者病变区、病变周边区存在神经元代谢异常及部分脑区激活,经功能磁共振(MRS及DTI)检查可反映神经元代谢异常及部分脑区激活状况,实现评估脑损害目的。

Objective:To explore the value of functional magnetic resonance imaging (MRI)in the assessment of brain damage in patients with convulsive status epilepticus (CSE).Methods:Nineteen patients with CSE from May 2015 to May 2017 were enrolled as the CSE group and 20 healthy subjects were seIected as the control group.The two groups were examined with magnetic resonance spectroscopy (MRS)and diffusion tensor imaging(DTI),and the Wechsler Memory Scale and the Montreal of Cognitive Assessment (MOCA)scale were used to evaluate their memory quotient (MQ) and detect MOCA total scores.Results:The values of NAA /Cr in the lesion area and lesion surrounding area of the CSE group were significantly lower than those of the control group (P<0.05).The Cho /Cr values in the lesion area and lesion surrounding area of the CSE group were significantly higher than those of the control group(P<0.05).The levels of MQ and MOCA of the CSE group were significantly lower than those of the control group (P<0.001).There was significantly positive correlations between MQ,MOCA with NAA /Cr in lesion area and lesion surrounding area and FAA in the bilateral hippocampus,amygdala and thalamic dorsal medial nucleus(P<0.05);There was significantly negative correlation between MQ,MOCA with Cho /Cr in the lesion area and lesion area(P<0.05). Conclusions:MRA and DTI can be used to detect the metabolic abnormality of neurons and the activation of some brain regions in the lesion area and lesion surrounding area.The assessment of brain damage is achieved by functional magnetic resonance imaging (MRS and DTI).