集成磁共振技术对常规MRI表现阴性颞叶内侧癫痫患者的定量研究

Quantitative measurement of medial temporal lobe epilepsy with negative MRI findings by synthetic magnetic resonance imaging

目的:探讨集成MRI(SyMRI)技术海马定量分析对常规MRI表现阴性的颞叶内侧癫痫(mTLE)患者的诊断价值。方法:将2020-2022年在本院经脑电图确诊为mTLE(左侧)且其常规MRI表现无明显异常(阴性)的34例患者纳入本研究,同期选取42例年龄相匹配的健康成年人作为对照组。所有受试者采用GE Signa Architect 3.0T磁共振仪进行头颅扫描,扫描序列包括常规序列(横轴面和矢状面T2WI)及MAGiC,利用GE MAGiC后处理软件测量双侧海马头的T_(1)、T_(2)、质子密度(PD)、R_(1)和R_(2)值。采用独立样本t检验或Mann-Whitney U检验比较癫痫组和对照组之间及2组内左、右侧之间海马头各项定量参数值的差异,采用ROC曲线评估组间差异有统计学意义的参数及其构建的联合模型对mTLE的诊断效能,并采用Delong检验比较各项参数及联合模型AUC的差异。结果:癫痫组左、右侧海马头的T_(1)和PD值均高于对照组,且左侧海马头的R_(1)值低于对照组同侧海马头,差异均有统计学意义(P<0.05)。T_(1)、PD、R_(1)及联合模型A(T_(1)+PD+R_(1))诊断mTLE的AUC分别为0.87、0.74、0.86和0.94。Delong检验结果:T_(1)、R_(1)与PD之间AUC的差异均有统计学意义(P<0.05),T_(1)与R_(1)之间AUC的差异无统计学意义(P>0.05);联合模型A的AUC高于3个单项指标及联合模型B(T_(1)+PD)、C(R_(1)+PD)和D(T_(1)+R_(1)),且差异均有统计学意义(P<0.05)。结论:SyMRI技术可以通过定量测量来反映癫痫患者海马的异常改变,为海马相关癫痫的早期诊断提供依据。

Objective:To investigate the value of quantitative measurement of hippocampus using synthetic magnetic resonance imaging(SyMRI)technique in the diagnosis of medial temporal lobe epilepsy(mTLE)with negative MRI findings.Methods:From 2020 to 2022,34 patients with EEG-confirmed mTLE(left side)and negative findings on conventional MR images in our hospital were recruited in this study,and 42 age-matched healthy adults were selected as the control group during the same period.All subjects underwent brain MRI examination using MAGiC(Magnetic Resonance Image Compilation)and conventional sequences(transverse and sagittal T_(2)WI)at a GE Signa Architect 3.0T MR scanner.The values of T_(1),T_(2),proton density(PD),R_(1) and R_(2) in bilateral hippocampus of each subjects were measured using GE MAGiC post-processing software.Independent sample t-test or Mann-Whitney U-test were used to compare the differences of quantitative parameters between the left and right sides of the case group and the control group,and between the left and right sides of the group.ROC curve was used to evaluate the diagnostic efficiency of parameters and combined models with statistically significant differences between groups for mTLE,and Delong test was used to compare the differences in AUC of each parameter and the combined model with multiple parameters.Results:The T_(1) and PD values of the left and right hippocampal heads in mTLE group were higher than those in the control group,the R_(1) value of the left hippocampal head was lower than that of the control group,and the differences were all statistically significant(P<0.05).The AUC of T_(1),PD,R_(1) and combined model A(T_(1)+PD+R_(1))for the diagnosis of mTLE were 0.87,0.74,0.86 and 0.94,respectively.Delong test results:the AUC between T_(1) and PD,and R_(1) and PD had statistical significance(both P<0.05),while the AUC between T_(1) and R_(1) had no statistical significance(P>0.05).The AUC of the combined model A was higher than that of the three single indexes(T_(1),PD,R_(1))and the combined model B(T_(1)+PD),C(PD+R_(1))and D(T_(1)+R_(1)),and the differences were statistically significant(all P<0.05).Conclusion:The SyMRI technique can provide important quantitative information for the early diagnosis of hippocampal-related epilepsy.