难治性癫痫的MRI改变探讨

The changes of MRI in refractory epilepsy

目的 探讨磁共振成像 (MRI)对难治性癫痫患者病因诊断的价值及其对治疗的指导作用。方法 分析 2 12例难治性癫痫患者的临床和MRI资料。结果 (1) 2 12例难治性癫痫患者中 ,118例MRI有改变 ,异常发现阳性率为 5 5 .7% (118/ 2 12 ) ,揭示的病因共 7种 ,其中以脑软化、脑发育异常多见 ;(2 )不同发作类型的MRI改变阳性率不同 ;(3)不同发作类型的MRI改变所揭示的病因不同 ;(4 )不同年龄组难治性癫痫患者MRI改变所揭示的病因不同。结论 头颅MRI扫描对难治性癫痫的病因诊断有重要意义 ,可为难治性癫痫确定治疗方向和选择治疗方法提供可靠依据 ,对判断难治性癫痫的预后有一定的指导意义。

Objective To probe the value of MRI (magnetic resonance imaging) in the etiological diagnosis and guidance usage in the treatment of the patients with refractory epilepsy. Methods 1.0T superconductive MR system (Magnetom Impact) provided by Germany Siemens Company was used in this research. 212patients with refractory epilepsy were given MRI examinations with routine SE sequences (T 1:TE600/TR15,T 2:TR2300/TE90). Results 1.In the 212 patients with refractory epilepsy, 118 had changes of MRI. Positive rate of abnormal findings was 55.7% (118/212). There were 7 kinds of diseases in which cerebromalacia and atelencephalia were most common.2. Different types of attacks had different positive rates of MRI changes.3. Different attack types'changes of MRI disclosed different etiologies.4. The MRI changes of different ages disclosed different etiologies.Conclusions Cranial MRI is of great use to the etiology diagnosis of refractory epilepsy.It can provide reliable guidance in determing treatment direction and selecting treatment plan in patients with refractory epilepsy.It is also important to the judgement of pragnosis of refractory epilepsy.