SWI对MRI阴性局灶性癫痫病因诊断中的价值

Evaluation of the etiology in magnetic resonance negative focal epilepsy by magnetic sensitivity-weighted imaging

目的 本研究旨在通过磁敏感加权成像序列(SWI)检查,研究其是否可提高发现局灶性癫痫患者的颅内可能病灶的检出率。方法 收集陕西省人民医院2020年1月至2021年12月诊断局灶起源的癫痫患者,对常规磁共振(MRI)检查阴性的患者加做SWI,观察SWI序列对病灶检出率,进一步对病因进行分析。结果 130例局灶起源的癫痫患者中,常规MRI结果阳性94例,占72%,MRI阴性患者36例,占28%,MRI阴性的36例患者行SWI检查,11例SWI显示阳性(30.6%),其中7例有脑创伤史,3例为脑小血管病变,1例为白血病所致脑微出血病变。结论 局灶起源的癫痫患者中,常规序列的MRI病灶检出率为72%,常规MRI为阴性患者通过SWI序列扫描显著提高了阳性病灶的检出率,提示对MRI阴性局灶性癫痫患者进行SWI序列具有重要意义。

Objective MRI-negative epilepsies refer to epilepsy without abnormalities in conventional MRI scans.This study aimed to investigate whether magnetic sensitivity-weighted imaging sequences could improve the detection rate of possible intracranial lesions in patients with focal epilepsy.Methods From january 2020 to december2021,video electroencephalography(VEEG) and head MRI were performed on 130 patients with focal origin epilepsy in Shaanxi Provincial People’s Hospital.For patients with abnormal electroencephalogram(EEG) and negative MRI,a SWI sequence was then performed to evaluate its detection rate of lesions,and the etiology was further analyzed.Results Among the 130 epilepsy patients,94 cases had positive MRI signal,accounting for 72% of all patients,and 36 cases had negative MRI signal,accounting for 28% of all patients.All the 36 MRI negative cases had SWI examination.There were 11 patients with positive signal in SWI screening,including 7 cases with brain injury,3 cases with cerebral small vessel disease,and 1 case with microhaemorrhagic lesion caused by leukemia.Conclusion In this study,we found that among patients with epileptic seizures identified as focal origin on the basis of VEEG and clinical seizure pattern,the detection rate of the primary lesion by conventional MRI was 72%,while 28% of patients remained negative.Through SWI sequence scanning,the detection rate of positive lesions was significantly improved,suggesting that it is of great significance to perform SWI sequence in patients with MRI-negative focal epilepsy.