1H-MRS联合DTI与海马硬化所致颞叶癫痫脑结构损害的关系分析

Relationship between 1H-MRS combined with DTI and cerebral structure damage of temporal lobe epilepsy caused by hippocampal sclerosis

目的通过1H-MRS联合DTI研究海马硬化所致颞叶癫痫脑结构损害。方法选取2017年1月至2019月5月收治的62例海马硬化所致颞叶癫痫患者以及同期体检的56例健康者为研究对象,分别作为研究组与对照组,均行1H-MRS与DTI检查,比较2组MRS相关指标,DTI相关指标,MRS、DTI指标对海马硬化所致颞叶癫痫影响,MRS、DTI指标对海马硬化所致颞叶癫痫诊断价值分析,患者MRS、DTI指标与癫痫严重程度相关性。结果研究组患侧NAA、NAA/(Cho+Cr)指标水平均显著低于研究组对侧与对照组(P<0.05),研究组对侧与对照组上述指标差异无统计学意义(P>0.05);研究组患侧ADC指标水平高于研究组对侧与对照组,FA值指标水平低于研究组对侧与对照组,差异有统计学意义(P<0.05);多元Logistic回归分析结果显示,NAA/(Cr+Cho)值、FA值为影响海马硬化所致颞叶癫痫发生高危因素(P<0.05);ROC曲线结果显示,NAA/(Cr+Cho)值与FA值联合诊断海马硬化所致颞叶癫痫诊断价值优于单一诊断(串联与并联AUC分别为0.713和0.827,单一诊断AUC分别为0.702和0.674);Pearson相关性分析结果显示,NAA/(Cr+Cho)值、FA值与利物浦癫痫严重程度量表2.0(liverpool seizure severity scale 2.0,LSSS 2.0)均显示为负相关(r=-0.419,-0.384;P<0.05)。结论1H-MRS与DTI可以有效反映海马硬化所致颞叶癫痫患者脑结构损害以及癫痫严重程度,两者结合用于诊断海马硬化所致颞叶癫痫价值较好。

Objective To investigate the cerebral structure damage of temporal lobe epilepsy caused by hippocampal sclerosis through 1H-magnetic resonance spectrum(MRS)combined with diffusion tensor imaging(DTI).Methods Sixty-two patients with temporal lobe epilepsy caused by hippocampal sclerosis who were admitted and treated in our hospital from January 2017 to May 2019 were enrolled as research group,and the 56 healthy people who underwent physical examination at the same period were enrolled as control group.The subjects in both groups underwent 1H-MRS and DTI examination.The MRS and DTI related indexes were observed and compared between the two groups.And the diagnostic value of the indexes in diagnosis of temporal lobe epilepsy caused by hippocampal sclerosis was analyzed,moreover,the correlation between MRS and DTI related indexes and the severity of the disease was analyzed.Results The levels of NAA and NAA/(Cho+Cr)on the affected side in research group were significantly lower than those on the opposite side and those in control group(P<0.05).There were no significant differences on the opposite side in the above indexes between research group and control group(P>0.05).And ADC levels on the affected side in research group were significantly higher than those on the opposite side and those in control group,however,the FA levels were significantly lower than those on the opposite side and those in control group(P<0.05).The results of multiple Logistic regression analysis showed that NAA/(Cr+Cho)and FA were high-risk factors of temporal lobe epilepsy caused by hippocampal sclerosis(P<0.05).ROC curves results showed that diagnostic value of NAA/(Cr+Cho)combined with FA in diagnosis of temporal lobe epilepsy caused by hippocampal sclerosis was superior to that by single diagnosis(AUC of series and parallel connection:0.713,0.827.AUC of single diagnosis:0.702,0.674).Pearson correlation analysis results showed that NAA/(Cr+Cho)and FA were negatively correlated with liverpool seizure severity scale 2.0(LSSS 2.0)(P<0.05).Conclusion 1H-MRS and DTI can effectively reflect the cerebral structure damage and the severity of temporal lobe epilepsy caused by hippocampal sclerosis,moreover,the combined diagnosis of both indexes is better.