海马硬化致颞叶癫痫的临床及磁共振成像诊断

The clinic and Magnetic resonance imaging diagnostic in patients with temporal lobe epilepsy by hippocampal sclerosis

目的研究磁共振成像(Magnetic resonance imaging,MRI)T2-flair序列对海马硬化的诊断价值。方法回顾性分析2019年3月—2020年12月于天水市第三人民医院癫痫中心就诊的135例海马硬化所致癫痫患者的临床资料,研究MRI T2-flair序列多轴位扫描中海马硬化信号变化与癫痫抽搐发作频率相关性。结果单纯性海马硬化109例,伴有其他病灶的海马硬化26例,其中合并海绵状血管瘤8例、外伤性或感染性软化灶9例、局灶性皮层发育不良2例、脑裂畸形1例、巨脑回1例、围产期脑损伤5例。海马硬化MRI影像特点为:①海马体积略增大、结构模糊、T2-flair显示海马信号略增高15例,占11.11%;②海马结构模糊、T2-flair呈斑点状高信号、体积无变化17例,占12.59%;③海马固缩成小团块状,T2-flair序列为高信号103例,占76.30%。统计发现海马硬化信号与抽搐发作频率具有相关性(χ^(2)=94.94,P<0.05),海马硬化信号越高、癫痫发作频率越高。结论MRI T2-flair序列多轴位扫描可提高海马硬化诊断准确性,海马硬化信号变化越明显,癫痫发作频率越呈增加趋势。

Objective The research goal:to study the diagnostic value of T2-flair sequence of magnetic resonance imaging(MRI)in hippocampal sclerosis.Methods The clinical data of 135 patients with epilepsy caused by hippocampal sclerosis in the Epilepsy Center of Tianshui Third People’s Hospital from March 2019 to December 2020 were analyzed retrospectively,studying the correlation between the changes of hippocampal sclerosis signal and the frequency of epileptic seizures in MRI T2-flair sequence multi axial scanning.Results There were 109 cases of simple hippocampal sclerosis and 26 cases of hippocampal sclerosis with other lesions,including 8 cases of cavernous hemangioma,9 cases of traumatic or infectious malacia,2 cases of focal cortical dysplasia,1 case of cerebral fissure malformation,1 case of giant gyrus and 5 cases of perinatal brain injury.MRI features of hippocampal sclerosis were as follows:hippocampal volume increased slightly,structure blurred,and T2-flair showed slightly increased hippocampal signal in 15 cases,accounting for 11.11%;The hippocampal formation was fuzzy,T2-flair was punctate hyperintense,and the volume did not change in 17cases(12.59%);Hippocampal pyknosis into small lumps,T2-flair sequence showed high signal in 103 cases,accounting for 76.30%.Statistics showed that there was a correlation between hippocampal sclerosis signal and seizure frequency(χ^(2)=94.94,P<0.05).The higher the hippocampal sclerosis signal,the more the seizure frequency.Conclusion MRI T2-flair sequence multi axial scanning can improve the diagnostic accuracy of hippocampal sclerosis.As the change of hippocampal sclerosis signal becomes more obvious,the trend of seizure frequency increases.