质子磁共振波谱对颞叶癫的诊断价值

Diagnostic value of proton magnetic resonance spectroscopy in temporal lobe epilepsy

目的 :评价磁共振质子波谱 (1HMRS)对颞叶癫的诊断价值。方法 :对 2 0例健康人和 18例颞叶癫病人进行1HMRS采集 ,并定量分析了癫痫病人的N 乙酰天门冬氨酸 (NAA)、肌酸 (Cr)和胆碱复合物(Cho)等代谢产物的变化。结果 :癫病人致癫灶NAA峰以及NAA/ (Cho +cr)、NAA/Cr和NAA/Cho比值低于病灶对侧 ,亦低于健康对照组。正常对照组NAA/ (Cho +Cr)值平均为 0 .78,双侧差别小于 0 .0 7。我们以NAA/ (Cho +Cr)值 <0 .6 8和双侧NAA/ (Cho+Cr)比值的差别 >0 .0 7为判断标准 ,18例颞叶癫病人中 ,16例为单侧MRS异常 ,2例为双侧异常。结论 :质子磁共振波谱能无创性探测脑组织内生化及代谢改变 ,是诊断颞叶癫的有效手段之一。

Objective:To evaluate the diagnostic value of proton magnetic resonamce spectroscopy(1H MRS) in temporal lobe epilepsy(TLE).Methods:1H MRS were performed on the hippocampi of 20 healthy volunteers and 18 patients with unilateral mesial TLE and the signals from N-acetylaspartate(NAA) Creatine+phosphocreating (Cr)and choline-Containing(Cho) were analyzed.Results:The concentration of NAA and the ratio of NAA/(Cho+Cr),NAA/Cr and NAA/Cho in epileptogenic foci were lower than that of the sites on the opposite side and control subjects. The NAA/(Cho+Cr)ratio of the normal control subjects was 0.78.NAA/(Cho+Cr)<0.68 and >0.07 of the difference of NAA/(Cho+Cr) of two sides were considered as the standards for the lateralization diagnosis of TLE,in 18 patients,16 patients had ipsilatral decrease,2 patients showing abnormalities in patients of temporal lobe epilepsy.Conclusion:1H MRS can provide biochemical and metabolic information of human brain. 1H MRS is a useful and effective diagnostic tool in the evaluation of TLE.