3.0T MRI在儿童癫痫疾病的临床应用价值

Clinical application value of 3.0T MRI in pediatric epilepsy

目的探讨GE 3.0T SIGNAArchitect多模态MRI技术在儿童癫痫疾病中的临床应用价值。方法回顾性分析广西壮族自治区妇幼保健院2021年6月~2024年4月临床诊断癫痫疾病0~12岁的MRI检查患者110例,男58例,女52例,年龄6.15±0.66岁。根据不同的检查设备将患者分为两组:A组(Philips 1.5T Achieva,n=55)采用矢位T2WI,轴位T1WI、T2WI、T2 FLAIR及DWI序列观察灰白质结构、脑回脑沟发育、颞叶海马结构大小体积及颅脑信号等;B组(GE 3.0T SIGNAArchitect,n=55)采用轴位全脑BRAVO T1等体素薄层扫描序列,轴位CUBE T2 FLAIR等体素薄层扫描序列,轴T2WI扫描双侧海马,矢位T2WI,轴位MUSE DWI、ASL、DTI序列及MRS单体素或多体素,观察灰白质结构、脑回脑沟发育、颞叶海马结构大小体积及颅脑信号、ASL灌注情况、DTI神经纤维素及FA值增减、MRS代谢产物谱线增减等。结果A组海马硬化/缩小5例(9.1%),皮层发育不良6例(10.9%),自身免疫性脑炎6例(10.9%),巨脑回畸形3例(5.5%);B组海马硬化/缩小15例(27.3%),皮层发育不良16例(29.1%),自身免疫性脑炎14例(25.5%),巨脑回畸形10例(18.2%),ASL异常灌注23例(41.8%),波普代谢异常9例(16.4%);扩散张量成像异常减少5例(9.1%);A组和B组头颅癫痫在海马硬化/缩小、皮层发育不良、自身免疫性脑炎、巨脑回畸形、ASL灌注、MRS、DTI的诊断差异均有统计学意义(P<0.05)。结论3.0T多模态MRI扫描技术对癫痫患者颅脑形态及功能具有更全面和精确的影像评价。

Objective To investigate the clinical application value of GE 3.0T SIGNA Architect multimodal MRI technology in children with epilepsy.Methods A retrospective analysis was performed on 110 MRI patients aged from 0 to 12 years old who were clinically diagnosed with epilepsy in Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from June 2021 to April 2024,including 58 males and 52 females,aged at 6.15±0.66 years old.Patients were divided into two groups according to different examination of inspection equipment.Group A(Philips 1.5T Achieva,n=55)underwent sagittal T2WI,axial T1WI,T2WI,T2 FLAIR,and DWI sequences,focusing on gray matter structure,gyral sulci development,temporal hippocampus structure and volume,and craniocerebral signals.Group B(GE 3.0T SIGNA Architect,n=55)underwent a more comprehensive set of scans including axial whole-brain BRAVO T1,axial CUBE T2 FLAIR,axial T2WI bilateral hippocampus,sagittal T2WI,axial MUSE DWI,ASL,DTI sequences,and MRS monomer or polyvoxel scanning.Gray matter structure,gyri sulci development,temporal hippocampus structure size and volume,craniocerebral signal,ASL perfusion,DTI nerve cellulose and FA value increase and decrease,MRS Metabolites spectrum line increase and decrease were observed.Results In group A,5 cases of hippocampal sclerosis/shrinkage(9.1%),6 cases of cortical dysplasia(10.9%),6 cases of autoimmune encephalitis(10.9%),3 cases of giant gyrus malformation(5.5%);In group B,15 cases of hippocampal sclerosis/shrinkage(27.3%),16 cases of cortical dysplasia(29.1%),14 cases of autoimmune encephalitis(25.5%),10 cases of macrogyrus malformation(18.2%),23 cases of abnormal ASL perfusion(41.8%),and 9 cases of abnormal bopp metabolism(16.4%).Diffusion tensor imaging abnormalities decreased by 5 cases(9.1%).The diagnostic differences of hippocampal sclerosis/shrinkage in cephalic epilepsy,cortical dysplasia,autoimmune encephalitis,giant gyri malformation,ASL perfusion,MRS,DTI between group A and group B were statistically significant(P<0.05).Conclusion 3.0T multimodal MRI scanning technique has a more comprehensive and accurate image evaluation of brain morphology and function in patients with epilepsy.