难治性癫痫患者海马灌注的3D-ASL成像评估

3D-ASL imaging assessment of hippocampal perfusion in patients with refractory epilepsy

目的探讨难治性癫痫患者采用磁共振动脉自旋标记(ASL)技术评估海马灌注情况的价值。方法筛选2019-11-2021-11郴州市第一人民医院的105例受试者,均行海马3D-ASL检查,分为3组(单侧颞叶异常放电组、单侧海马硬化组、健康对照组),分析海马脑血流量(CBF)值与难治性颞叶癫痫的关系。结果健康对照组、单侧颞叶异常放电组患侧与健侧海马、单侧海马硬化组患侧与健侧海马的CBF值分别为(52.13±0.95)mL/(100 g·min)、(49.03±5.28)mL/(100 g·min)、(54.97±1.63)mL/(100 g·min)、(39.41±2.01)mL/(100 g·min)、(48.03±1.69)mL/(100 g·min),除健康对照组与单侧颞叶异常放电组健侧、单侧颞叶异常放电组健侧与单侧海马硬化组健侧比较无统计学差异外,其余组间比较差异均有统计学意义(P<0.00625)。对比健康对照组与单侧颞叶异常放电组患侧得出cut-off值,ROC曲线的最佳临界点为45.81。结论ASL技术在全身及系统性疾病中有一定的诊断价值,难治性颞叶癫痫患者的海马灌注量变化相较于影像学改变更早,有利于临床早期诊断和治疗。

Objective To investigate the value of magnetic resonance arterial spin labeling(ASL)in evaluating hippocampal perfusion in patients with drug-resistant epilepsy.Methods One hundred and five subjects in the First People’s Hospital of Chenzhou from November 2019 to November 2021 were screened,all of whom underwent hippocampal 3D-ASL examination,and were divided into three groups(unilateral temporal lobe abnormal discharge group,unilateral hippocampal sclerosis group,healthy control group)to analyze the relationship between hippocampal cerebral blood flow(CBF)and intractable temporal lobe epilepsy.Results The CBF value of the healthy control group,unilateral temporal lobe abnormal discharge group,and unilateral hippocampal sclerosis group was(52.13±0.95)mL/(100 g·min),(49.03±5.28)mL/(100 g·min),(54.97±1.63)mL/(100 g·min),(39.41±2.01)mL/(100 g·min),and(48.03±1.69)mL/(100 g·min),respectively.Except that there was no statistical difference between healthy control group and unilateral temporal lobe abnormal discharge group,and between healthy side and unilateral hippocampal sclerosis group,there was statistically significant difference between other groups(P<0.00625).The cut-off value of the affected side was obtained by comparing the healthy subjects and the unilateral temporal lobe abnormal discharge group.The optimal critical point according to the ROC curve was 45.81.Conclusion ASL technology has certain diagnostic value in systemic and systemic diseases,and the changes in hippocampal perfusion volume in refractory temporal lobe epilepsy patients are earlier than imaging changes,which is beneficial for early clinical diagnosis and treatment.