海马、杏仁核和前颞叶体积测量对颞叶癫痫定侧诊断价值的研究

MRI Volumetric Measurement of the Hippocampus,Amygdala and Anterior Temporal Lobe for the Lateralization Diagnosis of Temporal Lobe Epilepsy

研究海马、杏仁核和前颞叶体积测量对颞叶癫痫定侧诊断价值。材料和方法 :以50例海马硬化患者和30例健康志愿者为研究对象 ,分别测量双侧海马、杏仁核和前颞叶的体积 ,并根据颅内容积大小行标化处理。以正常组体积的平均值减2倍标准差作为正常下限值来判断异常 ,定侧诊断以双侧体积差值为标准。结果 :50例海马硬化患者中 ,病侧海马绝对体积小于正常的占66 % ,其中双侧海马萎缩的占总数的20 %。病侧杏仁核和前颞叶体积小于正常的各占10 %。双侧海马体积差值 (DHF)准确定侧的占68 % ,双侧杏仁核体积差值 (DAM )和双侧前颞叶体积差值 (DATL)准确定侧的各占8 %和12 %。将海马绝对体积和DHF相结合定侧诊断率为76 %。结论 :MRI体积测量对颞叶癫痫具有重要定侧诊断价值 ,将海马绝对体积与DHF相结合可提高定侧诊断率。

Purpose:To evaluate the role of MRI volumetric measurement of hippocampal formation(HF),amygdala(AM)and anterior temporal lobe(ATL)for the lateralization diagnosis of temporal lobe epilepsy(TLE).Materials and Methods:50patients with hippocampal sclerosis(HS)and30healthy volunteers were studied.Both volumes of the HF,AM and ATL were measured and the resulting data normalized acˉcording to individual brain volume.We used the controlled mean value minus2SD as the low limit value for the judgement of abnormality.Difference of both volumes was used as the standard for the lateralˉization diagnosis.Results:Among the50cases of HS,66%had significant small HF volume on the ipsiˉlateral side.20%had bilateral hippocampal atrophy.The percentage of ipsilateral atrophy of AM and ATL volume was10%respectively.Difference of bilateral HF volume(DHF)made the correct lateralˉization in68%patients.Difference of bilateral AM volume(DAM)and difference of bilateral ATL volˉume(DATL)made the correct lateralization in only8%and12%patients respectively.When combining the absolute volume of HF with the DHF,the diagnostic rate was76%.Conclusion:MRI volumetry is of importance for the lateralization diagnosis of TLE.When combining the absolute volume of HF and the DHF value,the lateralization diagnostic rate is elevated.Volumetric measurement of the AM and ATL can not make the lateralization diagnosis.