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目的初步探讨磁共振波谱分析(proton magnetic resonance spectroscopy,1HMRS)在难治性颞叶癫痫病灶定位中的意义。方法采用PHLIPHS 3.0 T磁共振设备,PRESS CSI序列,对15例难治性癫痫患者和15例年龄、性别与之配对的健康志愿者分别取双侧海马40 mm×20 mm×10 mm大小区域进行多体素MRS分析,获得NAA、Cho、Cr的峰下面积,以颅内电极和术后病理为标准,探讨MRS在难治性癫痫患者病灶定位中的意义。结果15例谱线基线稳定,信噪比较好;13例癫痫患者1HMRS结果与正常对照组测值平均值比较发现异常,定位信息与颅内电极和病理符合。结论多体素短回波1HMRS(PRESS序列)可以发现常规MRI阴性的TLE患者海马区脑组织代谢的异常,对颞叶癫痫术前的病灶定位有较大意义。
Objective To investigate the significance of 1H MRS in the localization of intractable temporal lobe epilepsy. Methods Fifteen patients with refractory epilepsy and 15 healthy volunteers paired with age and gender were enrolled in the study. The bilateral Hippocampus 40 mm × 20 mm × 10 mm region were examined by PHLIPHS 3.0 T magnetic resonance imaging equipment and PRESS CSI. Multi-voxel MRS analysis, the area under the peak of NAA, Cho and Cr was obtained. The intracranial electrodes and postoperative pathology were used as criteria to explore the significance of MRS in the localization of focal lesions in patients with refractory epilepsy. Results The baseline of 15 cases was stable and the signal-to-noise ratio was good. The 1HMRS results of 13 cases of epilepsy were found to be abnormal compared with the average value of the normal control group. The localization information was consistent with the intracranial electrode and pathology. Conclusions Multi-voxel short-echo 1HMRS (PRESS sequence) can detect abnormal brain tissue metabolism in the hippocampus of patients with conventional MRI-negative TLE, which is of great significance for preoperative localization of temporal lobe epilepsy.