目的：应用氢质子磁共振波谱（1H-MRS）测量颞叶癫痫（TLE）患者双侧海马区主要代谢物N-乙酰天门冬氨酸（NAA），γ-氨基丁酸（GABA）及谷氨酸/谷氨酰胺复合物（GLx）的浓度变化，以期能更好的理解癫痫的发病机制，同时为TLE定位致痫灶提供更多的影像学支持。方法：对10例临床诊断TLE患者及14例正常志愿者进行双侧海马的常规MRI和1H-MRS扫描，测量NAA，Cr，Cho，GABA及GLx在患侧海马、对侧海马及正常对照组之间的浓度变化及各代谢物之间的相互关系。结果：患侧海马NAA较对侧海马及正常对照组均显著减低（P=0.001，P=0.007）。以年龄为控制因素做偏相关分析，患侧组NAA与GLx呈负相关（P=0.016），GABA与GLx亦呈负相关（P=0.024）。结论：TLE患者患侧海马NAA减低，可以为定位致痫灶提供依据。患侧海马区GABA和GLx较正常对照组存在不同改变，并且存在负相关性代谢变化，局部变化可能与癫痫的发作和治疗状态有关。
Abstract
Objective: To measure the changes of bilateral hippocampal metabolite concentrations in patients with temporal lobe epilepsy(TLE) by using proton magnetic resonance spectroscopy(1H-MRS). The main metabolites that we studied include N-acetylaspartate(NAA), γ-aminobutyric acid(GABA) and glutamate/glutamine compounds(GLx). These changes of the metabolite concentrations can make us further understand the pathogenesis of epilepsy, and provide more imaging support for locating the epileptic foci in TLE. Methods: Ten patients with TLE and 14 normal controls were studied. All subjects underwent bilateral hippocampal conventional MRI and 1H-MRS scans. The metabolite concentrations of NAA, Cr, Cho, GABA and GLx in the ipsilateral hippocampus were compared with the concentrations in the contralateral hippocampus and the normal control group. Results: NAA was significantly lower in the ipsilateral hippocampus than in the contralateral hippocampus and normal control group(P=0.001, P=0.007, respectively). By partial correlation analysis with the controlling factors of age, GLx and NAA were negatively correlated(P=0.016), and GABA and GLx are negatively correlated(P=0.024) in the ipsilateral hippocampus. Conclusion: NAA reduced in ipsilateral hippocampus in patients with temporal lobe epilepsy, which can provide the basis for the localization of epileptic foci. GABA and GLx in ipsilateral hippocampus have different changes compared with the normal control group with a negative correlation in metabolic changes, the local variations may be related with seizure and treatment status of epilepsy.
关键词
癫痫 /
颞叶 /
海马 /
磁共振成像
Key words
Epilepsy, frontal lobe /
Hippocampus /
Magnetic resonance imaging
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