【摘要】 目的 明确流动敏感交互反转恢复模式(FAIR)的脉冲式动脉自旋标记PASL)能否检测出发作间期颞叶内侧的低灌注,根据脑血流灌注变化确定致痫灶位置。方法 15例经过视频脑电图(VEEG)确诊的颞叶癫痫(TLE)病人和15例正常对照者行FAIR测量感兴趣区脑血流量(CBF)并计算相关数值。结果 对照组左、右颞叶内侧灌注分别是(169.64±13.24)mL(100 g·min)、(167.95±15.30) mL/(100 g·min)。病例组致痫灶同侧与对侧颞叶内侧灌注分别是(158.42±9.09) mL (100 g·min)、(170.11±7.67) mL/(100 g·min),两侧颞叶内侧血流量明显不同。对照组和病例组颞叶内侧灌注的不对称指数分别为2.49±2.09、7.20±4.21。虽然对照组颞叶内侧CBF也存在不对称性,病例组颞叶内侧CBF不对称指数(AI)明显大于对照组,AI差别存在统计学差异(P=0.001)。FAIR和VEEG对致痫灶定侧一致率达80%。结论 FAIR灌注成像可以检测出难治性TLE病人发作间期颞叶内侧CBF灌注减低,是对结构评估的有益补充。更多还原

【Abstract】 Objective To determine whether pulsed ASL(PASL) MRI using flow-sensitive alternating inversion recovery(FAIR)could be a useful clinical tool to detect interictal temporal hypoperfusion in mesial temporal lobe epilepsy(TLE),then on the base of changes of cerebral blood flow(CBF) to determine the seizure focus.Methods 15 normal controls and 15 patients were studied by using a FAIR perfusion mode to measure the CBF of mesial temporal lobe.According to the video-electroencephalography(VEEG)findings,the origin sides of seizure were obtained in all patients.Results Perfusion in control participants was(167.95±15.30)mL/(100 g·min) on the right and(169.64±13.24) mL/(100 g·min) on the left.In patients,mesial temporal lobe perfusion was(158.42±9.09) mL/(100 g·min) on the ipsilateral(affected) side and(170.11±7.67) mL/(100 g·min) on the contralateral(unaffected) side.The blood flow measurements were significantly different in ipsilateral versus contralateral sides in patients.In control participants,the mean absolute asymmetry index was 2.49±2.09.For the patients,mean absolute asymmetry index was 7.20±4.21.The difference was statistically significant(P=0.001).The coefficient of agreement for detecting the asymmetry with FAIR and with video-EEG lateralization was 80%.Conclusion MR perfusion imaging based on the FAIR technique is capable of detecting interictal hypoperfusion of mesial temporal lobe in patients with medically refractory temporal lobe epilepsy and provides complementary information to tests that assess structure.更多还原