颞叶癫痫患者发作间期内侧颞叶磁共振动态磁敏感对比增强灌注成像研究

The Study of the Medial Temporal Lobe Perfusion Changes in Patients with Temporal Lobe Epilepsy in Interictal Period by DSC Perfusion Imaging

目的采用动态磁敏感对比增强(dynamic susceptibility contrastenhanced,DSC)灌注成像探讨颞叶癫痫(temporal lobe epilepsy,TLE)患者发作间期内侧颞叶灌注改变。方法对经过手术病理证实的15例发作间期右利手TLE患者及相匹配15例正常对照者行DSC检查。在工作站上重建出DSC的相对脑血容量(relative cerebral blood volume,r CBV)图及相对脑血流量(relative cerebral blood flow,r CBF)图,结合高分辨率解剖像,选取两侧内侧颞叶作为感兴趣区(region of interest,ROI),计算病例组及正常对照组两侧内侧颞叶的r CBV值、r CBF值,比较病例组及正常对照组两侧内侧颞叶r CBV、r CBF的不对称指数(asymmetry index,AI)的差异。结果1、正常对照组双侧内侧颞叶r CBV值、r CBF值差异无统计学意义(P>0.05)。2、TLE组患侧r CBV值、r CBF值均低于对侧,差异有统计学意义(P<0.05)。3、TLE组AIr CBV、AIr CBF均高于正常对照组,差异有统计学意义(P<0.05)。4、TLE患者内侧颞叶AIr CBF值、AIr CBV值均与病程呈正相关。结论 TLE发作间期患侧内侧颞叶r CBV值、r CBF值降低,TLE患者的血流灌注改变与患者病程具有一定的相关性,表现为随着TLE患者病程的延长,其灌注不对称性越高。

Objective To investigate tbe medial temporal lobe peCnsion changes in patients with temporal lobe epilepsy （TLE） in interictal period using dynamic snsceptibility contrast enhanced （DSC） perfusion imaging. Methods 15 patients with pathologically confirmed right-handed TLE and matched 15 cases norntal control were underwent DSC examination. Reconstrncted the relative cerebral blood volume （rCBV） and relative cerebral blood flow （rCBF） using the workstation software, selected on both sides of the medial temporal lobe as region of interest combinedwith high-resolution anatomical image, then calculated the rCBV values, rCBF values and asymmetry index （AI）, and contpared the value between the the TLE group and the control group. Results 1. The rCBV and rCBF values in medial temporal lobe in normal control group showed no signifcant difference （P〉0.05）. 2. The rCBV and rCBF values in medial temporal lobe in affected side were lower than opposite side in TLE group, the difference was statistically significant （P〈0.05）. 3. The AIrCBV, AIrCBF in TLE group were higher than the normal control group, the difference was statistically significant （P〈0.05）. 4. AIrCBF and AlrCBV values in medial temporal lobe of TLE patients were positively correlated with disease course. Conclusion The rCBV and rCBF values were decreased in ntedial temporal lobe in patients with TLE in interictal period, the blood perfusion changes correlated with disease course in TLE patients, The longer the duration, the higher the perfusion asymmetry.