DTI对致痫性局灶性皮质发育不良病灶定侧意义的初步探讨

A preliminary study on the lateralizing significance of DTI of thalamus in epileptogenic focal cortical dysplasia

目的:探讨致痫性局灶性皮质发育不良(FCD)患者丘脑DTI参数的变化及其临床相关性。方法:选取致痫性FCD患者和正常对照组各15例,行DTI扫描,并手动测量2组双侧丘脑DTI参数,即ADC值及各向异性分数(FA)。2组丘脑ADC值及FA值比较行Levene检验,2组双侧丘脑各参数比较行配对t检验。结果:FCD组患侧丘脑FA值(0.249±0.034)低于对照组(0.268±0.037),差异有统计学意义(F=2.663,P=0.010);患侧丘脑ADC值[(8.727±0.420)×10^(-3)mm^(2)/s]低于对照组[(8.956±0.505)×10^(-3)mm^(2)/s],差异无统计学意义(F=1.817,P>0.05)。FCD组患侧丘脑的FA值与ADC值均低于对侧,差异均有统计学意义(t=5.473,P<0.001;t=3.212,P=0.006)。结论:致痫性FCD患者中双侧丘脑的DTI参数有着特殊改变,DTI在致痫性FCD的临床定侧及神经影像学机制的研究上具有一定的临床应用价值。

Objective:To explore the changes in DTI of thalamus in patients with epileptogenic focal cortical dysplasia(FCD),and its clinical relevance.Methods:Fifteen patients with epileptogenic FCD confirmed by surgical pathology and 15 normal controls were selected.All patients underwent DTI scanning,and ADC and fractional anisotropy(FA)values of bilateral thalamus were manually measured in two groups.The ADC and FA values of thalamus between FCD and control group were analyzed by Levene test,and the parameters of bilateral thalamus were compared with paired t test.Results:The FA value of thalamus of affected side in FCD group was(0.249±0.034),which was lower than that in normal group of(0.268±0.037)(F=2.663,P=0.010),and the ADC value of thalamus of affected side was(8.727±0.420)×10^(-3) mm^(2)/s,which was higher than that in control group of(8.956±0.505)×10^(-3) mm^(2)/s(F=1.817,P>0.05).The FA and the ADC values of thalamus of affected side in FCD group were lower than those of contralateral thalamus.Conclusions:There are special changes in DTI parameters of bilateral thalamus in patients with FCD.DTI has certain application value in the study of clinical lateralization and neuroimaging mechanism of epileptogenic FCD.