儿童睡眠中癫痫性电持续状态相关综合征的基于MRI体素形态学分析研究

MRI voxel-based morphological analysis of children with electrical status epilepticus during sleep related syndrome

目的采用基于MRI体素形态学分析法,分析儿童睡眠中癫痫性电持续状态(ESES)相关综合征患儿组及正常对照组的灰质体积改变。方法选取ESES患者组21例;正常对照组15例。利用3.0T Magnetom Skyra超导型MRI系统进行三维磁化准备快速梯度回波脉冲序列(3D-MPRAGE)数据采集,使用SPM8对数据进行基于体素形态学分析,得到两组被试的灰质体积。对灰质体积进行双样本t检验,对患者组的灰质体积和患者年龄、发病年龄、病程作Spearman相关性分析。结果1)与正常对照组相比,ESES组患者的视觉联合皮层(左枕下回、左侧舌回、左枕中回)、右颞中回、右侧丘脑、扣带回灰质体积减少;语言中枢(左额中回、左顶下回)、右颞下回、右缘上回、左中央前回、右中央后回灰质体积增加;2)患者组的灰质体积和年龄、发病年龄、病程间均无相关性(P值分别为0.57、0.31、0.33,均>0.05)。结论患者组可能存在视觉信息感知整合和语言功能异常。患儿不同脑区的灰质体积改变,可与临床症状相结合,为诊疗过程中了解患儿预后情况提供客观依据。

Objective Using the voxel-based morphological analysis method.We analyze the changes in gray matter volume in children with electrical status epilepticus during sleep related syndrome and healthy control group,and discuss its clinical significance.Methods Twenty-one children with ESES and 15 healthy controls were recruited.The 3.0 T Magnetom Skyra superconducting magnetic resonance imaging system was used for 3D magnetization preparation for three-dimensional magnetization prepared-rapid gradient echo pulse sequence(3D-MPRAGE)data acquisition,and the data were analyzed based on voxel morphology using SPM8 to obtain the gray matter volume of two groups of subjects.Two-sample t test was performed on the gray matter volume between groups,and Spearman correlation analysis was performed on the gray matter volume of the patient group with the patient's age,onset age and disease course.Results 1)Compared with the healthy control group,the volume of gray matter in the visual association cortex(left inferior occipital gyrus,left lingual gyrus,left middle occipital gyrus),right middle temporal gyrus,right thalamus,and cingulate gyrus decreased in the ESES group.The volume of gray matter increased in the speech center(left medial frontal gyrus,left inferior parietal gyrus),right inferior temporal gyrus,right marginal superior gyrus,left anterior central gyrus,right posterior central gyrus;2)There was no correlation between gray matter volume,age,age of onset and course of disease in the patient group(P values were 0.57,0.31,0.33,>0.05).Conclusion Patients may have integration of visual information perception and abnormal language function.The changes of gray matter volume in different brain areas in children can be combined with clinical symptoms to provide an objective basis for understanding the prognosis of children in the treatment process.