左侧颞叶癫痫患者颞叶以外白质的磁共振扩散张量成像分析

Diffusion tensor imaging analysis of extratemporal white matter in patients with left temporal lobe epilepsy

目的 探讨左侧颞叶癫痫患者颞叶以外白质磁共振扩散张量成像(DTI)的影像学特征。方法 选取2020年12月至2022年5月贵州医科大学第二附属医院收治的30例左侧颞叶癫痫患者作为观察组,并选取同期30例正常志愿者作为对照组,2组患者均进行DTI扫描,收集丘脑、内囊、外囊、放射冠及半卵圆中心白质区域的平均扩散率(MD)和部分各向异性(FA)值,分析颞叶以外白质区域MD和FA值与癫痫严重程度的相关性。结果 观察组患者丘脑、内囊、外囊、放射冠及半卵圆中心区域MD值高于对照组(P<0.05),而FA值低于对照组(P<0.05)。癫痫患者颞叶以外白质区域MD值与癫痫严重程度呈正相关(P<0.05),FA值呈负相关(P<0.05)。结论 DTI各参数能反映颞叶癫痫患者非病灶区纤维束的变化,这些区域神经纤维束的变化可能与癫痫的严重程度密切相关。

Objective To investigate the characteristics of diffusion tensor imaging(DTI) of extratemporal white matter in patients with left temporal lobe epilepsy(LTLE). Methods A total of 30 patients with LTLE from the Second Affiliated Hospital of Guizhou Medical University from December 2020 to May 2022 were selected as observation group, and 30 normal volunteers were collected during the same period as control group. Two groups were given with DTI scanning. Mean diffusivity(MD) and fraction anisotropy(FA) values of thalamus, internal capsule, external capsule, corona radiate and the center of semiovale were collected. The association of MD and FA values of extratemporal white matter with the severity of epilepsy was analyzed. Results In thalamus, inner capsule, outer capsule, corona radiata and the center of semicovale, MD values were higher in observation group than those in normal group(P<0.05), while FA values were lower in observation group than those in normal group(P<0.05). In patients with epilepsy, MD value of extratemporal white matter was positively correlated with the severity of epilepsy(P<0.05), while FA value was negatively correlated with the severity of epilepsy(P<0.05). Conclusion DTI parameters can reflect the changes of fiber bundles in non-focal areas of patients with LTLE. These changes of nerve fiber bundles may be closely related to the severity of epilepsy.