青壮年颞叶癫痫患者颞叶外脑结构的DTI研究

Extratemporal abnormalities of brain parenchyma in young adults with temporal lobe epilepsy:a diffusion tensor imaging study

目的利用扩散张量成像技术观察青壮年颞叶癫痫(TLE)患者颞叶外不同脑结构的DTI测值,观察其扩散功能的改变。方法采用GE公司3.0T磁共振检查了20例青壮年颞叶癫痫患者及20例与之匹配的健康对照组,选择双侧内囊前肢(AIC)、后肢(PIC)、外囊(EC)、尾状核头(HCN)、豆状核(LN)、丘脑(TL)及胼胝体膝部(GCC)、体部(BCC)、压部(SCC)为感兴趣区(ROI),评价指标为FA、ADC、λ∥及λ⊥。结果与对照组相比,TLE患者所有ROI的FA值均降低,双侧EC、HCN、TL及BCC的ADC值升高,患侧LN和双侧AIC、TL、GCC的λ∥降低,所有ROI的λ⊥均升高(仅双侧PIC的λ⊥未见明显差异)。TLE组患侧与对侧相比,患侧HCN的FA值较对侧减低。Pearson相关分析发现患者GCC的ADC值与发病年龄呈负相关,与病程呈正相关;患者GCC的λ⊥与病程呈正相关;患侧PIC的λ∥与发病年龄呈负相关,对侧AIC的λ⊥与病程呈负相关。结论 TLE患者可产生较广泛的大脑双侧半球的灰白质结构的异常;患者发病年龄越小、病程越长其胼胝体及内囊所受的影响就越严重。

Objective In this study, we evaluated extratemporal abnormalities in young adult patients with TLE utilizing DTI images. Methods We examined 20 young patients with unilateral TLE and 20 healthy controls using a 3. 0 T GE Signa EXCITE MR imaging scanner. Our ROIs included AIC, PIC, EC, HCN, LN, TL, FL, OL, CG, GCC, BCC, SCC. Four DTI parameters were used to quantitatively analyze the ROIs：FA, ADC,λ∥andλ⊥. Results In comparison to controls, TLE patients showed that FA was louer in all ROIs, ADC was higher in the bilateral ECs, HCNs, TLs and BCC,λ∥was louer in the ipsilateral LN, bilateral AICs, TLs, FLs, OLs, CGs and FR, GCC; and λ⊥ was higher in all the ROIs except the contralateral PIC. Using Pearson correlation analysis, we found a negative correlation between ADC of GCC and the epilepsy onset age, a positive correla-tion between ADC of GCC and the duration of epilepsy, a negative correlation betweenλ∥of ipilateral PIC and the epilepsy onset age, a negative correlation betweenλ⊥ of contralateral AIC and the duration of epilepsy, and a positive correlation betweenλ⊥of GCC and the duration of epilepsy. Conclusion DTI can be used to evaluate the extratemporal lobe changes in young patients with TLE noinvasively and effectively. The young patients with TLE with an younger onset age or longer duration of epilepsy have more serious extratemporal changes.