【摘要】 目的　应用MR氢质子波谱 (1HMRS)不同成像方法 ,包括单体素波谱 (SVS)、化学位移成像 (CSI) ,探讨1HMRS对颞叶癫痫 (TLE)的诊断价值。方法　设对照组 4 0例、颞叶癫痫组 (TLE) 2 0例。应用1HMRS分别进行海马结构 (HF)的SVS和CSI,应用SVS比较TLE患侧组、对侧组及对照组各代谢物比值 ,并行致痫灶定侧诊断。应用CSI分析TLE患侧组、对侧组及对照组HF从前到后各体素氮 乙酰天门冬氨酸 / (胆碱 +肌酸复合物 ) [NAA/ (Cho +Cr) ]的变化规律 ,并进行三组间、各体素间两两比较。结果　SVS示TLE组患侧组HF的NAA/ (Cho +Cr) (0 4 8± 0 10 )、NAA/Cr(1 2 0± 0 19)下降 ,与对照组、对侧组 (分别为 0 71± 0 0 7、1 4 8± 0 16 ;0 6 1± 0 12、1 4 4± 0 2 3)差异有显著性意义 (F值分别为 4 1 95 8、15 5 75 ,P值 <0 0 0 0 1)。SVS对TLE定侧敏感度为 85 % ,特异度为 93%。CSI示对照组、TLE患侧、对侧组HF的NAA/ (Cho +Cr)与HF部位间呈直线相关关系 ,后部较前部大 ;与正常组比较 ,患侧组前部NAA/ (Cho +Cr)的降低程度较后部大。结论　SVS可帮助TLE致痫灶定侧。CSI显示HF从前到后存在NAA/ (Cho +Cr)渐变现象 ,TLE患侧头部代谢改变较尾部大。在比较代谢改变时 ,保证定位于HF的相同部位很重要。更多还原

【Abstract】 Objective To investigate the value of different proton MR spectroscopy techniques including single-voxel spectroscopy (SVS) and chemical shift imaging (CSI) in diagnosing patients with temporal lobe epilepsy.Methods Sixty cases (40 normal, 20 temporal lobe epilepsy) experienced SVS and CSI. The volume of interest (VOI) of SVS was placed over the anterior hippocampus formation (HF) region, including part of the head and body of the HF. The VOI of CSI encompassed bilateral HF and the head, body and tail of HF. The VOI was divided into 5 voxels from anterior to posterior. The metabolite data of both SVS and CSI were obtained and the ratios of NAA/Cr and NAA/(Cho+Cr) were recorded or calculated.Results The ipsilateral hippocampus to the seizure of TLE patients had lower ratios of NAA/(Cho+Cr) and NAA/Cr, and the differences compared with those of the normal group and contralateral subgroup were statistically significant (F=41.958,P<0.001 and F=15.575,P<0.001,respectively). SVS had a sensitivity of 85% and a specificity of 93% for lateralization of seizure in TLE. CSI showed lower ratio of NAA/(Cho+Cr) in the anterior part as compared with the posterior part of the HF in normal subjects and both ipsilateral and contralateral HF of TLE patients. In the TLE group,the reduction degree of ipsilateral NAA/(Cho+Cr) was greater in voxels in the anterior HF region than in the posterior HF region compared with the control group.Conclusion 1HMRS study improved the diagnostic yield of MR evaluation in TLE patients. There was a correlation between the ratio of NAA/(Cho+Cr) and the location of HF. Regional variation must be considered when interpreting proton spectra of the HF.更多还原