论文部分内容阅读
目的探讨静息态功能性磁共振时间簇分析(TCA-fMRI)应用于难治性癫致灶术前定位的方法和价值。方法对11例难治性癫病人,在癫发作间期行静息态功能磁共振(fMRI)检查,应用TCA-fMRI技术计算与癫发作相关的脑内激活区(致区),并分析比较该激活区与术中皮质电极定位致灶之间的吻合程度。结果 TCA-fMRI确定的激活区与术中皮质电极定位的致灶一致6例;激活区范围扩大3例,但最强激活区仍与皮质电极定位的癫灶一致;激活区较弥散2例。术后病理显示:胶质瘤3例,脑软化灶4例,灰质异位症2例,海绵状血管瘤1例,海马萎缩1例。随访1年,术后3个月、6个月及1年均复查脑电图,癫发作消失8例,明显减少3例;无严重并发症。结论静息态TCA-fMRI技术是一种新型、无创性的致灶定位方法,将静息状态下致灶异常放电所导致的血氧依赖水平变化在MRI三维结构图像上显示,能在术前精确定位致灶。
Objective To investigate the method and value of resting state functional magnetic resonance time-series analysis (TCA-fMRI) for the preoperative localization of intractable epilepsy to fissure stovepipe. Methods Eleven patients with intractable epilepsy were examined by resting magnetic resonance imaging (fMRI) during the epileptic seizure. The brain activation (epidural area) related to epileptic seizures was calculated by TCA-fMRI technique. , And analyzed the degree of anastomosis between the active area and the intraoperative cortical electrode localization to the foci. Results The activation zone determined by TCA-fMRI was consistent with that of intraoperative cortical electrode localization in 6 cases. The activation zone was enlarged in 3 cases, but the strongest activation zone was still consistent with the epileptic foci located by cortical electrodes. The activation zone was more diffuse 2 example. Postoperative pathology showed three cases of glioma, four cases of cerebral softening, two cases of gray matter etiology, one case of cavernous hemangioma and one case of hippocampus atrophy. Follow-up 1 year, 3 months after surgery, 6 months and 1 year review EEG, epileptic seizures disappeared in 8 cases, significantly reduced in 3 cases; no serious complications. Conclusion The resting TCA-fMRI technique is a new and noninvasive method of locating foci. The changes of blood oxygen dependency caused by abnormal discharge of foci under resting state are shown in the three-dimensional MRI images. Accurate positioning of the preoperative foci.