基于DCE-MRI衍生参数在脑囊虫病所致癫痫复发评估中的价值

Value of DCE-MRI-derived parameters in the evaluation of epilepsy recurrence caused by cerebral cysticercosis

目的探讨基于动态对比增强MRI(DCE-MRI)衍生参数在脑囊虫病(CC)所致癫痫复发评估中的价值。方法回顾性分析2020年1至12月于云南省保山市第二人民医院接受治疗的40例CC所致癫痫急性发作患者的临床资料,其中男性22例、女性18例,年龄(35.6±11.0)岁。依据在半年内癫痫是否复发,将所有患者分为复发组和未复发组。分别于患者首次入院和随访半年后观察和记录所有患者的DCE-MRI衍生参数:速率常数(K_(ep))、容积转移常数(K^(trans))和血管外细胞外间隙容积分数(V_(e))。2组间比较采用独立样本t检验或χ^(2)检验。结果40例患者中,复发组16例、未复发组24例。2组患者的性别、年龄、癫痫首次发作时间和癫痫发作类型的差异均无统计学意义(χ^(2)=0.020,t=0.692,t=0.902,χ^(2)=0.030,均P>0.05)。首次入院检测时,未复发组患者的K_(ep)、V_(e)和K^(trans)水平分别为(30.17±5.32)×10^(−2)/min、(102.32±6.58)×10^(−2)、(19.98±2.64)×10^(−2)/min,显著低于复发组[(36.32±4.36)×10^(−2)/min、(110.35±7.12)×10^(−2)、(23.21±3.21)×10^(−2)/min],且差异均有统计学意义(t=3.839、3.660、3.477,均P<0.001)。随访半年后检测时,未复发组患者的K_(ep)、V_(e)和K^(trans)水平分别为(12.57±3.29)×10^(−2)/min、(78.02±4.36)×10^(−2)、(17.96±3.01)×10^(−2)/min,亦显著低于复发组[(24.25±3.58)×10^(−2)/min、(90.37±8.27)×10^(−2)、(23.32±3.98)×10^(−2)/min],且差异均有统计学意义(t=10.620、10.161、4.848,均P<0.001)。结论基于DCE-MRI衍生参数可以分析BBB的通透性,对CC所致癫痫的复发评估具有重要价值。

Objective To explore the value of derived parameters based on dynamic contrastenhanced MRI(DCE-MRI)in the evaluation of epilepsy recurrence caused by cerebral cysticercosis(CC).Methods Forty patients with acute epilepsy caused by CC treatment in the Second People's Hospital of Baoshan City,Yunnan Province from January to December 2020 were analyzed retrospectively,including 22 males and 18 females,aged(35.6±11.0)years.On the basis of whether epilepsy has recurred within 6 months,all patients were divided into a recurrent group and a nonrecurrent group.The DCE-MRI-derived parameters,such as rate constant(K_(ep)),volume transfer constant(K^(trans)),and extravascular extracellular volume fraction(V_(e)),were observed and recorded in all patients at first admission and 6 months after follow-up.Independent sample t-test orχ^(2)test was used for intergroup comparison.Results Among the 40 patients,16 were in the recurrent group,and 24 were in the non-recurrent group.No significant difference in general data,such as gender,age,first seizure time,and epilepsy types,existed between the two groups(χ^(2)=0.020,t=0.692,t=0.902,χ^(2)=0.030,all P>0.05).At the first admission,the levels of K_(ep),V_(e),and K^(trans) in the non-recurrent group were(30.17±5.32)×10^(−2)/min,(102.32±6.58)×10^(−2),and(19.98±2.64)×10^(−2)/min,respectively,which were significantly lower than those in the recurrent group((36.32±4.36)×10^(−2)/min,(110.35±7.12)×10^(−2),(23.21±3.21)×10^(−2)/min),and the differences were statistically significant(t=3.839,3.660,3.477,all P<0.001).Six months after follow-up,the levels of K_(ep),V_(e),and K^(trans) in the non-recurrent group were(12.57±3.29)×10^(−2)/min,(78.02±4.36)×10^(−2),and(17.96±3.01)×10^(−2)/min,respectively,which were also significantly lower than those in the recurrent group((24.25±3.58)×10^(−2)/min,(90.37±8.27)×10^(−2),(23.32±3.98)×10^(−2)/min),and the differences were statistically significant(t=10.620,10.161,4.848,all P<0.001).Conclusion BBB permeability can be analyzed via DCE-MRI-derived parameters,which has important value in evaluating the recurrence of epilepsy caused by CC.