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目的评价弥散张量成像(DTI)对于常规MRI未发现病灶的部分性继发全面性发作癫痫患者的病灶检出能力。方法使用Siemens 3.0T磁共振成像系统对30例成年继发全面性发作癫痫患者和30例正常对照者进行扫描,得到弥散加权成像,采用基于体素的分析方法对癫痫患者和正常对照组的数据进行分析。结果癫痫组右侧梭状回和楔前叶、右侧额内侧回和钩回、左侧扣带回、左侧颞下回、左侧小脑扁桃体和左侧中央前回的脑区FA值较正常对照组降低,差异有统计学意义(P<0.001);癫痫组右侧海马旁回、右侧颞下回、右侧胼胝体、右侧额内侧回、右侧额下回、扣带回、右侧前扣带回、右侧舌回、右侧梭状回和枕中回,左侧颞中回、左侧钩回和左侧中央前回的脑区ADC值较正常对照组升高,差异具有统计学意义(P<0.001);左侧直回的脑区ADC值较正常对照组降低,差异具有统计学意义(P<0.001)。结论 DTI检查可发现常规MRI检查为阴性的部分性继发全面性发作癫痫患者存在的广泛脑白质微结构异常。
Objective To evaluate the ability of diffuse tensor imaging (DTI) to detect focal lesion in patients with partial seizures of generalized seizures without lesions. Methods Thirty patients with adult secondary generalized epilepsy and 30 normal controls were scanned with Siemens 3.0T magnetic resonance imaging system to obtain diffusion weighted imaging. Data of patients with epilepsy and normal controls were analyzed by voxel-based analysis Analyze. Results In the epilepsy group, the FA values of the fusiform gyrus and the anterior wedge lobe, the right medial gyrus and the gyrus, the left cingulate gyrus, the left inferior temporal gyrus, the left cerebellar tonsillar and the left central anterior gyrus were higher than those of the normal (P <0.001). In the epilepsy group, the right parahippocampal gyrus, the right inferior temporal gyrus, the right corpus callosum, the right frontal medullary gyrus, the right inferior cerebellar gyrus, the cingulate gyrus and the right ADC values of the anterior cingulate gyrus, right lingual gyrus, right fusiform gyrus and middle occipital gyrus, left middle temporal gyrus, left lateral gyrus and left middle anterior gyrus were higher than those in normal control group Statistical significance (P <0.001); left brain recurred brain ADC value was lower than the normal control group, the difference was statistically significant (P <0.001). Conclusions The DTI examination can reveal extensive abnormalities of white matter microstructure in patients with partial seizures of generalized onset seizures who are negative on conventional MRI.