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海马磁共振波谱分析在颞叶癫痫症中的价值

海马磁共振波谱分析在颞叶癫痫症中的价值
李伟龙晚生罗学毛陈曼琼兰勇何义改
目的探讨海马氢质子磁共振波谱分析(1H-MRS)在颞叶癫痫症中的应用价值。


法采用Philips Achieva 1.5 T双梯度磁共振扫描仪,对38例颞叶癫痫患者和20例健康志愿者行
颅脑MRI和海马1H-MRS检查,观察NAA、Cr、Cho浓度和NAA/(Cho+Cr)、NAA/Cr和NAA/Cho值。

分别对癫痫患者病灶侧与正常侧,病灶侧与正常对照组海马的NAA/(Cho+Cr)、NAA/Cr和NAA/Cho
值进行t检验,分析两者之间差异有无显著性。

结果癫痫患者组癫痫侧、正常侧和对照组海马
的NAA/(Cho+Cr)值分别为(0.42±0.06)、(0.67±0.09)、(0.72±0.07),癫痫组癫痫侧与正常侧、对
照组比较差异有显著性(P<0.05),而正常侧与对照组比较差异无显著性(P>0.05)。

以NAA/
(Cho+Cr)来检出癫痫,灵敏度曲线呈现低→高→低的变化,在0.60时,灵敏度最高。

结论1H-
MRS不仅能早期诊断海马硬化,而且可进一步提高术前癫痫灶定位的准确性。

海马;磁共振;氢质子波谱;癫痫
Value of hippocampal magnetic resonance spectroscopy in temporal lobe epilepsy dis
ease LI Wei LONG Wan-sheng LUO Xue-mao CHEN Man-qiong LAN Yong HE Yi-gai Depart
ment of Radiology, Jiangmen Central Hospital, Jiangmen 529030, China 
Objective To study the application value of hippocampus proton magnetic reso
nance spectroscopy (1H-MRS) in temporal lobe epilepsy. Methods With Philips Achieva 1.5T dual gradient MR scanner, 38 patients with temporal lobe epilepsy and 20 healthy volunteers were underwent brain MRI and hippocampal 1H-MRS examination, observation indicators included the concentration of NAA, Cr, Cho and the value of NAA/(Cho+Cr), NAA/Cr and NAA/Cho. The NAA/(Cho+Cr), NAA.Cr and NAA/Cho values in hippocampus of epilepsy side of epilepsy group, the normal side of epilepsy group, and the normal control group had a t test, analyzing the statistical difference between the two groups.Results The NAA/(Cho+Cr) values in hippocampal of the epilepsy side of epileptic patients, the normal side of epileptic patients and the control group were (0.42+0.06), (0.67+0.09), (0.72+0.07), respectively, there was significant difference between the epilepsy side and the normal side of epileptic patients, and between the epilepsy side of epileptic patients and the control group(P<0.05), but no significant difference between the normal side of epileptic patients and the control group(P>0.05). Using NAA/(Cho+Cr) to detect epilepsy, the sensitivity curve showed low→high→low changes, the highest sensitivity appeared in 0.60.Conclusion 1H-MRS not only has early diagnosis to hippocampal sclerosis, but also improves the accuracy of preoperative localization of epileptic focus,
Hippocampal; Magnetic Resonance; Proton Magnetic Resonance Spectroscopy;
Epilepsy 
10.3760/cma.i.issn. 1007-1245.2011.18.012 
529030 江门市中心医院放射科
万方数据
2240万方数据
万方数据
@@[1] Briellmann RS, Mark Wellard R, Masterton RA, et al.
Hippocampal sclerosis: MR prediction of seizure 
intractability[J]. Epilepsia, 2007, 48(2): 315-323.
@@[2] Hajek M, Dezortova M, Krsek P, et al. 1H MR Spec
troscopy in epilepsy[J]. EurJ Radiol, 2008, 67(2) 258-
267.
@@[3] Hammen T, Schwarz M, Doelken M, et al. 1H-MRS 
indicates severity lnarkers in temporal lobe epilepsy:
correlations between metabolic aherations, seizures, and 
epileptic discharges in EEG[J]. Epileltsia, 2007, 48
(2): 263-269.
万方数据
@@[4] Willmann O, Weunherg R, May T, et al. The role of 1H magnetic resonance spectroscopy in pre-operative evalu ation for epilepsy surgery:. A meta analysis[J]. Epilepsy Res, 2006, 71(2-3) 149-158.
@@[5] Pulsipher DT, Seidenberg M, Moaon JJ, et al. MRI volume loss of subeortical structures in unilateral tem
poral lobe epilepsy[J]. Epilepsy Behavior, 2007, 11(3): 442-449.
@@[6] Soares DP, Law M. Magnetic resonance spectroscopy of the brain: review of metabolites and clinical applications [J]. Clin Radiol, 2009, 64(1): 12-21.@@[7] DoeIken MT, Stefan H, PauIi E, et al. 1H-MRS profile in MRI positive versus MRI negative patients with tem poral lobe epilepsy[J]. Seizure, 2008, 17(6): 490-497.@@[8] Hammen T, Hildebrandt M, Stadlbauer A, et al. Non invasive detection of hippocampal sclerosis correlation between metabolite alterations detected by 1H-MRS and neuropathology[J]. NMR Biomed, 2008, 21(6): 545- 552.
2011-05-19
射频治疗慢性肥厚性咽炎200例临床分析朱贵浩朱贵霞刘媚
目的探讨射频治疗慢性肥厚性咽炎的疗效。

方法将200例慢性肥厚性咽炎患者随机分为两组,观察组100例用射频治疗咽部增生淋巴滤泡,对照组100例予常规药物治疗,比较两组疗效。

结果观察组100例中,治愈75例,有效19例,无效6例,总有效率为94.00%;对照组100例中,治愈35例,有效42例,无效23例,总有效率为77.00%;两组疗效比较差异具有极显著性(P<0.01)。

结论射频治疗慢性肥厚性咽炎操作简便安全,损伤小,无明显不良反应,疗效显著。

慢性肥厚性咽炎;射频治疗;疗效
10.3760/cma.j .issn. 1007-1245.2011.18.013
514500 兴宁市人民医院耳鼻喉科
万方数据。

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