T_(1)WI-3D-MPRAGE在难治性癫痫海马及杏仁核体积上的成像研究

T_(1)WI-3D-MPRAGE Imaging Study on the Volume of Hippocampus and Amygdala in Refractory Epilepsy

目的利用T_(1)WI-3D-MPRAGE研究难治性癫痫(RE)患者与正常人海马及杏仁核体积的差异。方法回顾性收集22名难治性颞叶癫痫患者纳入病例组(RE组),22名健康体检人员纳入对照组(HC组),两组人员均接受T_(1)WI-3D-MPRAGE扫描,并借助FreeSurfer软件测量双侧海马和杏仁核体积,使用两独立样本t检验对各成员双侧海马和杏仁核体积进行统计分析,以评价上述指标对于难治性癫痫(RE)的诊断价值。结果RE组左侧海马和杏仁核体积显著低于RE组右侧和HC组同侧(P<0.05);RE组右侧海马和杏仁核体积与HC组同侧差异无统计学意义(P>0.05);HC组左侧海马体积显著低于右侧(P<0.05);HC组左、右侧杏仁核体积差异无统计学意义(P>0.05);ROC曲线结果显示,海马及杏仁核体积联合诊断难治性癫痫的价值优于单一诊断(联合诊断AUC为0.709,单一诊断AUC分别为0.700、0.676)。结论海马及杏仁核体积可以有效反映难治性癫痫患者局部脑结构改变,两者联合诊断难治性癫痫价值较好,而T_(1)WI-3D-MPRAGE序列可实现脑组织的精细成像。

Objective To explore the difference of hippocampal and amygdala volume between patients with refractory epilepsy(RE)and normal subjects by T_(1)WI-3D-MPRAGE.Methods 22 patients with refractory epilepsy were retrospectively collected as case group(RE group)and 22 healthy volunteers as control group(HC group).Both groups were scanned by T_(1)WI-3D-MPRAGE,and the volumes of bilateral hippocampus and amygdala were measured by FreeSurfer software.Two independent sample t-test was used to analyze the bilateral hippocampal and amygdala volumes of each member to evaluate the diagnostic value of the above indexes in refractory epilepsy(RE).Results The volumes of left hippocampus and amygdala in RE group were significantly lower than those in right side of RE group and ipsilateral side of HC group(P<0.05).There was no significant difference in the volume of right hippocampus and amygdala between;RE group and HC group(P>0.05).The volume of left hippocampus in;HC group was significantly lower than that of right hippocampus(P<0.05).There was no significant difference between left and right amygdala volume in;HC group(P>0.05).ROC curves results showed that the value of combined diagnosis of refractory epilepsy with hippocampal and amygdala volume was better than that of single diagnosis(AUC of combined diagnosis was 0.709,AUC of single diagnosis was 0.700 and 0.676,respectively).Conclusion The volume of hippocampus and amygdala can effectively reflect the changes of local brain structure in patients with refractory epilepsy.The combination of hippocampal and amygdala volume is of good value in the diagnosis of refractory epilepsy,while T_(1)WI-3D-MPRAGE plays an important role in fine imaging of brain tissue.