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目的探讨应用术中1.5T核磁共振(MRI)治疗难治性癫癎的手术效果。方法手术治疗难治性癫癎15例,利用术中1.5T核磁共振,术前常规行T1、T2及T1加强,及弥散张量成像,术中切除(切开)后行T1、T2及T1加强及弥散张量成像检查,以确定切除范围及功能区定位,其中5例术中MR检查后扩大切除。结果左侧枕叶局灶性皮质发育异常2例,左侧颞叶海绵状血管瘤4例,左侧颞叶海马硬化1例,右侧额叶胚胎发育不良性神经上皮肿瘤1例,右侧中央前回局灶性皮质发育不良1例,右侧颞叶海马硬化1例,右侧颞叶海绵状血管瘤1例,右侧颞叶胶质瘤1级1例,右侧中央后回海绵状血管瘤1例,胼胝体切开2例,engle分级:Ⅰ级11例,Ⅱ级4例。结论术中1.5T核磁共振对切除(切开)病灶及功能保护有指导意义。
Objective To investigate the effect of intraoperative 1.5T MRI in the treatment of refractory epilepsy. Methods Fifteen patients with intractable epilepsy were treated surgically by 1.5T nuclear magnetic resonance (MRI). The patients underwent preoperative T1, T2 and T1 enhancement and diffusion tensor imaging. All the patients underwent resection (incision) and T1, T2 and T1 Strengthen and diffuse tensor imaging examination to determine the excision range and functional area positioning, including 5 cases of resection after MR examination. Results There were 2 cases of focal cortical dysplasia on the left occipital lobe, 4 cases of cavernous hemangioma on the left temporal lobe, 1 case of hippocampal sclerosis on the left temporal lobe, 1 case of neuroepithelial neoplasia on the right side of the frontal lobe, Central front anterior focal cortical dysplasia in 1 case, right temporal hippocampus sclerosis in 1 case, right temporal lobe cavernous hemangioma in 1 case, right temporal lobe glioma in 1 case, right middle back back to cavernous 1 case of hemangioma, 2 cases of corpus callosum, engle classification: grade Ⅰ in 11 cases and grade Ⅱ in 4 cases. Conclusions Intraoperative 1.5T MRI can be helpful for resection (incision) lesion and functional protection.