多模态磁共振成像在儿童癫痫的诊断价值

Diagnastic value of multimodal magnetic resonance imaging in children with epilepsy

目的探讨多模态磁共振成像成像在儿童癫痫中的应用价值。方法收集临床诊断为癫痫的患儿磁共振成像资料50例,50例全部行常规癫痫序列扫描,包括3D-T1FSPGR、3D-T2flair及轴位T2FSE序列,对在常规序列上表现阴性的患儿加扫冠状位高分辨T2FSpropeller序列、海马区多体素波谱分析(MRS)及全颅动脉自旋标记灌注成像(ASL)。结果50例患儿中常规序列诊断为皮层发育不良9例,半侧巨脑畸形6例,海马硬化6例;其余29例经冠位T2FSE序列诊断为海马旋转不良4例,MRS显示海马代谢异常7例,左侧5例,右侧2例,ASL显示不同脑区、不同程度低灌注21例。结论常规癫痫扫描序列阴性的患儿存在海马旋转不良、代谢异常及部分脑区的低灌注,多模态磁共振成像有助于对癫痫患儿颅脑形态和功能异常进行更全面、准确的影像学评估。

Objective To investigate the application value of multimodal magnetic resonance imaging in children with epilepsy.Methods Fiftycases of children with clinically diagnosed epilepsy were enrolled in this study.All the 50 cases underwent conventional epilepsy sequence,including 3D-T1 FSPGR,3D-T2flair and axial T2 FSpropellersequence,additional sequences such as coronal high-resolutionT2 propeller,multivoxel magnetic resonancespectroscopy analysis inhippocampaand whole cranial artery spin labeling perfusion imaging(ASL)were performed in children with negative results on conventional sequence.Results Among the 50 cases,9 cases were diagnosed as cortical dysplasia,6 cases as hemimegacephaly and 6 cases as hippocampal sclerosis on conventional sequence;The rest 29 cases were diagnosed as hippocampal dysrotationoncoronal T2FSE sequence,7 cases showed abnormal hippocampal metabolism,5 cases on the left side and 2 cases on the right side;21 cases showed different degrees of hypoperfusionin different brain regions on ASL.Conclusion Abnormal hippocampal rotation,metabolic abnormalities and hypoperfusion in some brain regions exist in children with negative results on conventional epilepsy sequence.Multimodal magnetic resonance imaging is helpful to make a more comprehensive and accurate imaging evaluation of brain morphology and function abnormalities in children with epilepsy.